Provider Demographics
NPI:1699273680
Name:SUNSERI, CRYSTAL DAWN (LPC)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:DAWN
Last Name:SUNSERI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:726 SAINT THOMAS ST
Mailing Address - Street 2:
Mailing Address - City:GALLITZIN
Mailing Address - State:PA
Mailing Address - Zip Code:16641-1338
Mailing Address - Country:US
Mailing Address - Phone:814-330-0538
Mailing Address - Fax:
Practice Address - Street 1:429 PARK PL
Practice Address - Street 2:
Practice Address - City:WINDBER
Practice Address - State:PA
Practice Address - Zip Code:15963-1718
Practice Address - Country:US
Practice Address - Phone:814-509-8110
Practice Address - Fax:814-509-8110
Is Sole Proprietor?:No
Enumeration Date:2018-01-25
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC010116101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional