Provider Demographics
NPI:1912656612
Name:SUNRISE PSYCHIATRY INC
Entity Type:Organization
Organization Name:SUNRISE PSYCHIATRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SONNI
Authorized Official - Middle Name:PATRECE
Authorized Official - Last Name:ELLIOTT-LIBUTSI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-333-0448
Mailing Address - Street 1:6900 COLLEGE BLVD STE 740
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1841
Mailing Address - Country:US
Mailing Address - Phone:913-333-0448
Mailing Address - Fax:913-444-2913
Practice Address - Street 1:6900 COLLEGE BLVD STE 740
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1841
Practice Address - Country:US
Practice Address - Phone:913-333-0448
Practice Address - Fax:913-444-2913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-21
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty