Provider Demographics
NPI:1568532257
Name:SUNSHINE, ELIZABETH ANNE (LICSW)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ANNE
Last Name:SUNSHINE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MRS
Other - First Name:E
Other - Middle Name:ANNE
Other - Last Name:SUNSHINE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSW
Mailing Address - Street 1:BOSTON BEHAVIORAL MEDICINE
Mailing Address - Street 2:1371 BEACON ST., SUITE 304
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:20446-4905
Mailing Address - Country:US
Mailing Address - Phone:617-777-3153
Mailing Address - Fax:
Practice Address - Street 1:64 ELDREDGE ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458-2017
Practice Address - Country:US
Practice Address - Phone:617-969-4925
Practice Address - Fax:617-969-2507
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1137121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical