Healthcare Provider Details
I. General information
NPI: 1508613845
Provider Name (Legal Business Name): SUNSHINE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/03/2024
Last Update Date: 05/03/2024
Certification Date: 05/03/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
401 HALL ST SW
GRAND RAPIDS MI
49503-5098
US
IV. Provider business mailing address
69 ROGUE RIVER VIEW DR NE
ROCKFORD MI
49341-8244
US
V. Phone/Fax
- Phone: 616-500-3304
- Fax:
- Phone: 231-652-0122
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEPHANIE
BARRETTE
Title or Position: OWNER/THERAPIST
Credential: LMSW
Phone: 231-652-0122