Provider Demographics
NPI:1487393435
Name:SUNFLOWER COUNSELING, LLC
Entity type:Organization
Organization Name:SUNFLOWER COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:CLEARY
Authorized Official - Last Name:URBAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:410-262-1021
Mailing Address - Street 1:638 PROSPECT AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105-4203
Mailing Address - Country:US
Mailing Address - Phone:410-262-1021
Mailing Address - Fax:
Practice Address - Street 1:638 PROSPECT AVE FL 3
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105-4203
Practice Address - Country:US
Practice Address - Phone:410-262-1021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-28
Last Update Date:2022-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1558593798Medicaid