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General NPI Number Information
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NPI Number | 1417776394
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Entity Type | Organization
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Legal Business Name | SUN LIGHT WELLNESS, LLC
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Dates
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Enumeration Date | 10/07/2024
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Last Update Date | 10/07/2024
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Provider Practice Location Address
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Address Line | 300 N 10TH ST STE 2
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City | RICHMOND
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State | IN
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Zip | 47374-3116
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Country | US
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Telephone | 812-266-0027
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Fax |
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Provider Business Mailing Address
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Address Line | 1708 S F ST
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City | RICHMOND
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State | IN
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Zip | 47374-6466
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Country | US
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Telephone | 765-977-6921
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | SUNNIE ALLEN
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Credential | LMHC, LCAC
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Telephone | 765-977-6921
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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