MEDICARE: SUNRISE THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1518365188
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNRISE THERAPY LLC

Provider Business Mailing Address
First Line	:	213 ROBINSON ST UNIT 10
Second Line	:
City	:	WAKEFIELD
State	:	RI
Zip	:	02879-3656
Country	:	US
Telephone Number	:	401-284-3044
Fax Number	:

Provider Business Practice Location Address
First Line	:	213 ROBINSON ST UNIT 10
Second Line	:
City	:	WAKEFIELD
State	:	RI
Zip	:	02879-3656
Country	:	US
Telephone Number	:	401-284-3044
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MEGAN BERNDT
Credential	:	LICSW
Telephone Number	:	401-284-3044

Provider Enumeration Date	:	12/15/2014
Last Update Date	:	01/20/2015

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Directions to “SUNRISE THERAPY LLC ” Practice Location

Language	Start Address	Practice Location

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