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General NPI Number Information
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NPI Number | 1023646106
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Entity Type | Organization
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Legal Business Name | SUNRISE COUNSELING PSYCHOLOGY INC
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Dates
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Enumeration Date | 04/01/2020
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Last Update Date | 04/01/2020
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Provider Practice Location Address
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Address Line | 511 N MUR LEN RD STE A
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City | OLATHE
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State | KS
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Zip | 66062-1208
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Country | US
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Telephone | 816-360-9221
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Fax |
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Provider Business Mailing Address
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Address Line | 511 N MUR LEN RD STE A
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City | OLATHE
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State | KS
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Zip | 66062-1208
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Country | US
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Telephone | 816-360-9221
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. DOMINICK SCALISE
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Credential | PH.D. LP
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Telephone | 573-680-1671
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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