Provider Demographics
NPI:1548784507
Name:SUNRISE COUNSELING AND PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:SUNRISE COUNSELING AND PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC, NCC
Authorized Official - Phone:757-694-4723
Mailing Address - Street 1:780 LYNNHAVEN PKWY STE 340
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-7361
Mailing Address - Country:US
Mailing Address - Phone:757-694-4723
Mailing Address - Fax:757-301-8803
Practice Address - Street 1:780 LYNNHAVEN PKWY STE 340
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-7361
Practice Address - Country:US
Practice Address - Phone:757-694-4723
Practice Address - Fax:757-301-8803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty