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NPI Code Detail

MEDICARE: MS. ELIZABETH ANNE SUNSHINE LICSW

MEDICARE: MS. ELIZABETH ANNE SUNSHINE LICSW
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
11041C0700XClinical Social Worker113712MA

General Provider Information

NPI Number : 1568532257
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELIZABETH ANNE SUNSHINE LICSW
Provider Business Mailing Address
First Line : BOSTON BEHAVIORAL MEDICINE
Second Line : 1371 BEACON ST., SUITE 304
City : BROOKLINE
State : MA
Zip : 20446-4905
Country : US
Telephone Number : 617-777-3153
Fax Number :
Provider Business Practice Location Address
First Line : 64 ELDREDGE ST
Second Line :
City : NEWTON
State : MA
Zip : 02458-2017
Country : US
Telephone Number : 617-969-4925
Fax Number : 617-969-2507
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2006
Last Update Date : 04/23/2018

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