Provider Demographics
NPI:1295455459
Name:SUNRISE MENTAL HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:SUNRISE MENTAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:FABIANA
Authorized Official - Middle Name:ARETUSA
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:860-201-3710
Mailing Address - Street 1:900 WASHINGTON ST STE 1012
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-2932
Mailing Address - Country:US
Mailing Address - Phone:860-201-3710
Mailing Address - Fax:
Practice Address - Street 1:32 OXFORD DR
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-1823
Practice Address - Country:US
Practice Address - Phone:860-201-3710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-29
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health