Provider Demographics
NPI:1427814193
Name:SUNLIGHT PSYCHOTHERAPY LLC
Entity type:Organization
Organization Name:SUNLIGHT PSYCHOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:JENICE
Authorized Official - Middle Name:
Authorized Official - Last Name:ACOSTA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:917-524-9372
Mailing Address - Street 1:597 W SIDE AVE
Mailing Address - Street 2:PMB 120
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-1709
Mailing Address - Country:US
Mailing Address - Phone:917-524-9372
Mailing Address - Fax:
Practice Address - Street 1:19 MILLER ST
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-1122
Practice Address - Country:US
Practice Address - Phone:917-524-9372
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1245794007OtherPERSONAL TYPE 1 NPI NUMBER