Healthcare Provider Details

I. General information

NPI: 1386555613
Provider Name (Legal Business Name): SUNLIT PSYCHOTHERAPY LCSW
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 AMADOR STREET
STATEN ISLAND NY
10303
US

IV. Provider business mailing address

656 FLATBUSH AVE
BROOKLYN NY
11225-5606
US

V. Phone/Fax

Practice location:
  • Phone: 646-656-0423
  • Fax:
Mailing address:
  • Phone: 646-656-0423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: HAILEY DAWSON
Title or Position: OWNER
Credential:
Phone: 646-656-0423