MEDICARE: MS. KAREN ELIZABETH SUMI LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MFC42907	CA
2	106H00000X	Marriage & Family Therapist	MFT.0001606	CO

General Provider Information

NPI Number	:	1609082544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAREN ELIZABETH SUMI LMFT

Provider Business Mailing Address
First Line	:	4307 MILL CREEK CT
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-3444
Country	:	US
Telephone Number	:	408-858-0745
Fax Number	:

Provider Business Practice Location Address
First Line	:	343 W DRAKE RD STE 280
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80526-6317
Country	:	US
Telephone Number	:	408-858-0745
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	10/08/2019

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