Provider Demographics
NPI:1568569267
Name:ZAMERINSKY-LUSSIER, RANDY ENID (MA, LICSW)
Entity Type:Individual
Prefix:MS
First Name:RANDY
Middle Name:ENID
Last Name:ZAMERINSKY-LUSSIER
Suffix:
Gender:F
Credentials:MA, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:IMA-EUROPE ATTN: SFIM-EU-HR(SAIC-ASACS)
Mailing Address - Street 2:UNIT 29353, BOX 200
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09014-9353
Mailing Address - Country:US
Mailing Address - Phone:49622-116-3912
Mailing Address - Fax:49622-157-8943
Practice Address - Street 1:IMA-EUROPE ATTN: SFIM-EU-HR(SAIC-ASACS)
Practice Address - Street 2:UNIT 29353, BOX 200
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09014-9353
Practice Address - Country:US
Practice Address - Phone:49622-116-3912
Practice Address - Fax:49622-157-8943
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN060011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical