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General NPI Number Information
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NPI Number | 1902606098
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Entity Type | Organization
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Legal Business Name | BORDER BEHAVIORAL THERAPY LLC
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Dates
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Enumeration Date | 03/17/2025
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 131 HARRISVILLE MAIN ST # 1
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City | HARRISVILLE
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State | RI
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Zip | 02830-9998
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Country | US
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Telephone | 401-465-2726
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1
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City | HARRISVILLE
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State | RI
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Zip | 02830-0001
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Country | US
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Telephone | 401-465-2726
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Fax |
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Authorized Official
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Title or Position | LICENSED INDEPENDENT CLINICAL SOCIA
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Name | SHERI LYNN BRISSETTE
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Credential | LICSW
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Telephone | 401-465-2726
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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