Provider Demographics
NPI:1508398769
Name:AKHTAR, SUJI LEE (LMFT108607)
Entity Type:Individual
Prefix:MRS
First Name:SUJI
Middle Name:LEE
Last Name:AKHTAR
Suffix:
Gender:F
Credentials:LMFT108607
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27200 TOURNEY RD STE 175
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-4990
Mailing Address - Country:US
Mailing Address - Phone:323-447-5847
Mailing Address - Fax:
Practice Address - Street 1:27200 TOURNEY RD STE 175
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91355-4990
Practice Address - Country:US
Practice Address - Phone:323-447-5847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFTI91982106H00000X
CALMFT108607106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist