SUNRISE PARK PSYCHOTHERAPY LCSW PC NPI 1376288530

NPI Information

NPI: 1376288530
Provider Name: SUNRISE PARK PSYCHOTHERAPY LCSW PC
Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
1228 WANTAGH AVE STE 111
WANTAGH, NY
ZIP 11793
Phone: (516) 644-6495
Get Directions

SUNRISE PARK PSYCHOTHERAPY LCSW PC is an adult mental health clinic center in Wantagh, NY. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. SUNRISE PARK PSYCHOTHERAPY LCSW PC NPI is 1376288530. The provider is registered as an organization entity type.

The provider's business location address is:

1228 WANTAGH AVE STE 111
WANTAGH, NY
ZIP 11793-209
Phone: (516) 644-6495
Fax: (516) 324-3143

The provider's authorized official is Gina Marie Cubillos .
The authorized official title is Owner/provider and has the following contact phone number (516) 644-6495.

The enumeration date for this NPI number is 5/2/2022 and was last updated on 5/2/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0850X	Clinic/Center	Adult Mental Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1048692	OTHER	NEW YORK	BEACON HEALTH OPTIONS
2	NKN592	OTHER	NEW YORK	BCBS ANTHEM ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »