Provider Demographics
NPI:1396226817
Name:THE SUNSHINE AGENCY, LLC
Entity Type:Organization
Organization Name:THE SUNSHINE AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAKESHIA
Authorized Official - Middle Name:RENAY
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:706-580-7262
Mailing Address - Street 1:3575 MACON RD STE 7
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31907-8227
Mailing Address - Country:US
Mailing Address - Phone:706-580-7262
Mailing Address - Fax:706-243-4243
Practice Address - Street 1:3575 MACON RD STE 7
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31907-8227
Practice Address - Country:US
Practice Address - Phone:706-580-7262
Practice Address - Fax:706-243-4243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-23
Last Update Date:2021-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008611101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GALPC008611OtherLICENSE
GA003213657AMedicaid