MEDICARE: SUNSCAPE COUNSELING, LLC

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
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1336765676
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNSCAPE COUNSELING, LLC

Provider Business Mailing Address
First Line	:	3434 HANCOCK BRIDGE PKWY STE 205
Second Line	:
City	:	NORTH FORT MYERS
State	:	FL
Zip	:	33903-7005
Country	:	US
Telephone Number	:	518-844-1675
Fax Number	:

Provider Business Practice Location Address
First Line	:	3434 HANCOCK BRIDGE PKWY STE 205
Second Line	:
City	:	NORTH FORT MYERS
State	:	FL
Zip	:	33903-7005
Country	:	US
Telephone Number	:	518-844-1675
Fax Number	:	239-294-3937

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	AMY POLSINELLI
Credential	:	LCSW
Telephone Number	:	518-844-1675

Provider Enumeration Date	:	06/23/2020
Last Update Date	:	06/27/2025

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