Provider Demographics
NPI:1972168029
Name:TSURNOS, SASHA ANN (LMSW, PSPIII, CDCS)
Entity type:Individual
Prefix:
First Name:SASHA
Middle Name:ANN
Last Name:TSURNOS
Suffix:
Gender:F
Credentials:LMSW, PSPIII, CDCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 W SANDVIK DR
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99623-0504
Mailing Address - Country:US
Mailing Address - Phone:650-278-6511
Mailing Address - Fax:
Practice Address - Street 1:300 N. WILLOW ST
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654
Practice Address - Country:US
Practice Address - Phone:650-278-6511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-03
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
AK207552101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor