Provider Demographics
NPI:1487862637
Name:SUNZERI, ELIZABETH J (MS, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:J
Last Name:SUNZERI
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92651 HEATHER LN
Mailing Address - Street 2:
Mailing Address - City:COOS BAY
Mailing Address - State:OR
Mailing Address - Zip Code:97420-7246
Mailing Address - Country:US
Mailing Address - Phone:541-266-7669
Mailing Address - Fax:866-906-9321
Practice Address - Street 1:92651 HEATHER LN
Practice Address - Street 2:
Practice Address - City:COOS BAY
Practice Address - State:OR
Practice Address - Zip Code:97420-7246
Practice Address - Country:US
Practice Address - Phone:541-266-7669
Practice Address - Fax:866-906-0321
Is Sole Proprietor?:No
Enumeration Date:2007-05-20
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORTO589106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR1487862637Medicare PIN