Provider Demographics
NPI:1588088298
Name:SUNRISE COUNSELING
Entity type:Organization
Organization Name:SUNRISE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:KELLIE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:VALENTINE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:814-490-4821
Mailing Address - Street 1:208 E BAYFRONT PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16507-2413
Mailing Address - Country:US
Mailing Address - Phone:814-871-6333
Mailing Address - Fax:814-871-6335
Practice Address - Street 1:208 E BAYFRONT PKWY STE 200
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-2413
Practice Address - Country:US
Practice Address - Phone:814-871-6333
Practice Address - Fax:814-871-6335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-17
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003951101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty