Provider Demographics
NPI:1043935265
Name:SUTHERLAND, ARYSA (LPC)
Entity Type:Individual
Prefix:
First Name:ARYSA
Middle Name:
Last Name:SUTHERLAND
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ARYSA
Other - Middle Name:
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:89 FERNANDEZ CIR
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-4905
Mailing Address - Country:US
Mailing Address - Phone:617-980-9930
Mailing Address - Fax:
Practice Address - Street 1:89 FERNANDEZ CIR
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-4905
Practice Address - Country:US
Practice Address - Phone:617-980-9930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA493467101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool