Provider Demographics
NPI:1225391261
Name:SUNSHINE CHILD & FAMILY COUNSELING
Entity Type:Organization
Organization Name:SUNSHINE CHILD & FAMILY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTEL
Authorized Official - Middle Name:DONNA
Authorized Official - Last Name:HIMELSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, NCC, LPC
Authorized Official - Phone:678-492-2352
Mailing Address - Street 1:288 S MAIN ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-7916
Mailing Address - Country:US
Mailing Address - Phone:678-492-2352
Mailing Address - Fax:678-302-0190
Practice Address - Street 1:288 S MAIN ST
Practice Address - Street 2:SUITE 300
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-7916
Practice Address - Country:US
Practice Address - Phone:678-492-2352
Practice Address - Fax:678-302-0190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-22
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004745251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003121562AMedicaid