Provider Demographics
NPI:1760088595
Name:SUNGLOW COUNSELING, LLC
Entity Type:Organization
Organization Name:SUNGLOW COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SWEENEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-774-7596
Mailing Address - Street 1:1038 SE OCEAN BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996-2599
Mailing Address - Country:US
Mailing Address - Phone:772-774-7596
Mailing Address - Fax:772-264-3838
Practice Address - Street 1:1038 SE OCEAN BLVD STE C
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34996-2599
Practice Address - Country:US
Practice Address - Phone:772-774-7596
Practice Address - Fax:772-264-3838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-08
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)