Provider Demographics
NPI:1841321460
Name:TSUTSUMI, MARIKO SARA (LP, LMHC)
Entity type:Individual
Prefix:MS
First Name:MARIKO
Middle Name:SARA
Last Name:TSUTSUMI
Suffix:
Gender:F
Credentials:LP, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 5TH AVE APT 9N
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8837
Mailing Address - Country:US
Mailing Address - Phone:212-995-5813
Mailing Address - Fax:
Practice Address - Street 1:2 5TH AVE APT 9N
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8837
Practice Address - Country:US
Practice Address - Phone:212-995-5813
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY130101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health