Healthcare Provider Details

I. General information

NPI: 1043177447
Provider Name (Legal Business Name): SUNRISE MENTAL HEALTH COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 CANDLE RD
MONROE NY
10950-5314
US

IV. Provider business mailing address

84 CANDLE RD
MONROE NY
10950-5314
US

V. Phone/Fax

Practice location:
  • Phone: 646-388-0392
  • Fax:
Mailing address:
  • Phone: 646-388-0392
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: JENNIFFER GONZALEZ
Title or Position: OWNER
Credential: LMHC
Phone: 646-388-0392