Provider Demographics
NPI:1679891626
Name:EREZ, SOPHIA DEBORAH (MS, LMFT, LPC)
Entity Type:Individual
Prefix:
First Name:SOPHIA
Middle Name:DEBORAH
Last Name:EREZ
Suffix:
Gender:F
Credentials:MS, LMFT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10645 N ORACLE RD STE 121254
Mailing Address - Street 2:
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85737-9387
Mailing Address - Country:US
Mailing Address - Phone:520-302-5851
Mailing Address - Fax:
Practice Address - Street 1:10645 N ORACLE RD STE 121254
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85737-9387
Practice Address - Country:US
Practice Address - Phone:520-302-5851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-13
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC 15896101YM0800X
CAMFC 48930106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist