| Sunrise Counseling Services Llc | |
|
3929 Lamar Dr Ste A Clarksville TN 37040-7354 | |
| (931) 494-6803 | |
| (888) 332-3984 |
| Full Name | Sunrise Counseling Services Llc |
|---|---|
| Speciality | Counselor |
| Location | 3929 Lamar Dr Ste A, Clarksville, Tennessee |
| Authorized Official Name and Position | Jacqueline Carlisle-berkley (OWNER/THERAPIST) |
| Authorized Official Contact | 9314946803 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunrise Counseling Services Llc 3929 Lamar Dr Ste A Clarksville TN 37040-5083 Ph: (931) 494-6803 | Sunrise Counseling Services Llc 3929 Lamar Dr Ste A Clarksville TN 37040-7354 Ph: (931) 494-6803 |
| NPI Number | 1780191114 |
|---|---|
| Provider Enumeration Date | 01/08/2018 |
| Last Update Date | 09/03/2021 |
| Certification Date | 09/03/2021 |
| Medicare PECOS PAC ID | 3476959149 |
|---|---|
| Medicare Enrollment ID | O20210903000559 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780191114 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 3208 (Tennessee) | Primary |
| Provider Name | Denise Goin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225330822 PECOS PAC ID: 9335574169 Enrollment ID: I20200123003093 |
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