| Sunrise Collaborative, Llc. | |
|
1048 Pennsylvania Ave W Warren PA 16365-1838 | |
| (724) 422-3928 | |
| (814) 313-1075 |
| Full Name | Sunrise Collaborative, Llc. |
|---|---|
| Speciality | Social Worker |
| Location | 1048 Pennsylvania Ave W, Warren, Pennsylvania |
| Authorized Official Name and Position | Michael Richard Philhower (OWNER/LICENSED CLINICAL SOCIAL WORK) |
| Authorized Official Contact | 7244223928 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunrise Collaborative, Llc. 1048 Pennsylvania Ave W Warren PA 16365-1838 Ph: (814) 230-9111 | Sunrise Collaborative, Llc. 1048 Pennsylvania Ave W Warren PA 16365-1838 Ph: (724) 422-3928 |
| NPI Number | 1023553369 |
|---|---|
| Provider Enumeration Date | 12/22/2016 |
| Last Update Date | 10/06/2020 |
| Certification Date | 10/06/2020 |
| Medicare PECOS PAC ID | 9739429994 |
|---|---|
| Medicare Enrollment ID | O20190326000568 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023553369 | NPI | - | NPPES |
| Provider Name | Kim Kibbey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851459671 PECOS PAC ID: 0840327755 Enrollment ID: I20100426000291 |
| Provider Name | Michael R Philhower |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790964260 PECOS PAC ID: 1456526953 Enrollment ID: I20111212000826 |
| Provider Name | Laurie A Fenton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053687186 PECOS PAC ID: 7012169741 Enrollment ID: I20150507002195 |
| Provider Name | Jennifer M Malone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619267127 PECOS PAC ID: 5698903425 Enrollment ID: I20150605000811 |
| Provider Name | Shahnawaz Meer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922261080 PECOS PAC ID: 1254501059 Enrollment ID: I20190326001886 |
| Provider Name | Amy J Philhower |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245733765 PECOS PAC ID: 5092055186 Enrollment ID: I20190328000455 |
| Provider Name | Rachel E King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780299495 PECOS PAC ID: 8224457684 Enrollment ID: I20201005000369 |
| Provider Name | Kellie Marie Spilka |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033874193 PECOS PAC ID: 6103215983 Enrollment ID: I20211117000139 |
| Provider Name | Deborah Maureen Meabon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609543123 PECOS PAC ID: 9739578212 Enrollment ID: I20211123001394 |
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