Provider Demographics
NPI:1801463179
Name:SUNSHYNE COUNSELING, PLLC
Entity type:Organization
Organization Name:SUNSHYNE COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:MC
Authorized Official - Phone:386-943-9040
Mailing Address - Street 1:1109 W EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-6553
Mailing Address - Country:US
Mailing Address - Phone:386-943-9040
Mailing Address - Fax:
Practice Address - Street 1:1109 W EUCLID AVE
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-6553
Practice Address - Country:US
Practice Address - Phone:386-943-9040
Practice Address - Fax:386-943-9937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH19281OtherTHE DEPARTMENT OF HEALTH