Provider Demographics
NPI:1124394200
Name:SUNRISE PROFESSIONAL COUNSELING & CONSULTATION, PLLC
Entity Type:Organization
Organization Name:SUNRISE PROFESSIONAL COUNSELING & CONSULTATION, PLLC
Other - Org Name:SUNRISE PROFESSIONAL COUNSELING & CONSULTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:LORETTA
Authorized Official - Middle Name:J
Authorized Official - Last Name:ZERILLI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:480-776-3391
Mailing Address - Street 1:70 S VAL VISTA DR. #A3-689
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296
Mailing Address - Country:US
Mailing Address - Phone:480-776-3391
Mailing Address - Fax:
Practice Address - Street 1:914 S. SILVERADO ST
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296
Practice Address - Country:US
Practice Address - Phone:480-776-3391
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-22
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-10547101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty