Provider Demographics
NPI:1164172029
Name:SUNFLOWER RADIANCE COUNSELING LLC
Entity Type:Organization
Organization Name:SUNFLOWER RADIANCE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:KILROY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, LPCMH, NCC
Authorized Official - Phone:267-854-7715
Mailing Address - Street 1:106 E COOKE AVE
Mailing Address - Street 2:
Mailing Address - City:GLENOLDEN
Mailing Address - State:PA
Mailing Address - Zip Code:19036-1404
Mailing Address - Country:US
Mailing Address - Phone:267-854-7715
Mailing Address - Fax:
Practice Address - Street 1:106 E COOKE AVE
Practice Address - Street 2:
Practice Address - City:GLENOLDEN
Practice Address - State:PA
Practice Address - Zip Code:19036-1404
Practice Address - Country:US
Practice Address - Phone:267-854-7715
Practice Address - Fax:267-481-7172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-24
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty