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NPI Code Detail

MEDICARE: SUNNY SIDE UP PSYCHOTHERAPY PLLC

MEDICARE: SUNNY SIDE UP PSYCHOTHERAPY PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1326768961
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUNNY SIDE UP PSYCHOTHERAPY PLLC
Provider Business Mailing Address
First Line : 4965 PRESTON PARK BLVD STE 700
Second Line :
City : PLANO
State : TX
Zip : 75093-5141
Country : US
Telephone Number : 214-760-6963
Fax Number :
Provider Business Practice Location Address
First Line : 1820 PRESTON PARK BLVD STE 2200
Second Line :
City : PLANO
State : TX
Zip : 75093-3614
Country : US
Telephone Number : 214-760-6963
Fax Number :
Authorized Official
Title or Position : OWNER
Name : BA BUNANSA
Credential : MS, LPC, NCC, BC-TMH
Telephone Number : 214-760-6963
Provider Enumeration Date : 09/01/2022
Last Update Date : 02/07/2026

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Directions to “SUNNY SIDE UP PSYCHOTHERAPY PLLC ” Practice Location

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