Provider Demographics
NPI:1902121387
Name:SKVENISON, LLC
Entity Type:Organization
Organization Name:SKVENISON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMFT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH KATE
Authorized Official - Middle Name:
Authorized Official - Last Name:VENISON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:203-241-9044
Mailing Address - Street 1:166 EAST AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-5731
Mailing Address - Country:US
Mailing Address - Phone:203-241-9044
Mailing Address - Fax:203-299-0015
Practice Address - Street 1:166 EAST AVE STE 203
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-5731
Practice Address - Country:US
Practice Address - Phone:203-241-9044
Practice Address - Fax:203-299-0015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001249106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1891965240OtherMHN