Provider Demographics
NPI:1396415725
Name:SUNRISE COUNSELING AND LIFE COACHING, PLLC
Entity Type:Organization
Organization Name:SUNRISE COUNSELING AND LIFE COACHING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, MHC
Authorized Official - Phone:570-216-2764
Mailing Address - Street 1:2641 N FLAMINGO RD APT 2103N
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-1748
Mailing Address - Country:US
Mailing Address - Phone:570-216-2764
Mailing Address - Fax:
Practice Address - Street 1:2641 N FLAMINGO RD APT 2103N
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-1748
Practice Address - Country:US
Practice Address - Phone:570-216-2764
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-16
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)