Provider Demographics
NPI:1588444566
Name:SUNRISE THERAPY AND CONSULTING LLC
Entity type:Organization
Organization Name:SUNRISE THERAPY AND CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BETHANY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DELANGE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:605-518-9162
Mailing Address - Street 1:2601 S MINNESOTA AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-4750
Mailing Address - Country:US
Mailing Address - Phone:218-443-1119
Mailing Address - Fax:
Practice Address - Street 1:5024 S BUR OAK PL STE 109
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-2237
Practice Address - Country:US
Practice Address - Phone:218-443-1119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty