=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386433043
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SUNRISE COUNSELING SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/30/2025
-----------------------------------------------------
Last Update Date | 04/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 101 PAUAHI ST STE 101
-----------------------------------------------------
City | HILO
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96720-4224
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-640-4805
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | HC 1 BOX 5438
-----------------------------------------------------
City | KEAAU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96749-9532
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-640-4895
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGING MEMBER
-----------------------------------------------------
Name | LOUONA M. LARKSPUR
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 808-640-4895
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------