Sunrise Psychological Services, Inc. | |
1717 Heritage Lake Dr Dayton OH 45458-6067 | |
(614) 961-2203 | |
Not Available |
Full Name | Sunrise Psychological Services, Inc. |
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Speciality | Psychologist |
Location | 1717 Heritage Lake Dr, Dayton, Ohio |
Authorized Official Name and Position | Melanie Anne Bergsten (PRESIDENT) |
Authorized Official Contact | 6149612203 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Sunrise Psychological Services, Inc. 1717 Heritage Lake Dr Dayton OH 45458-6067 Ph: (614) 961-2203 | Sunrise Psychological Services, Inc. 1717 Heritage Lake Dr Dayton OH 45458-6067 Ph: (614) 961-2203 |
NPI Number | 1932125648 |
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Provider Enumeration Date | 07/14/2006 |
Last Update Date | 12/01/2010 |
Medicare PECOS PAC ID | 1456308279 |
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Medicare Enrollment ID | O20050405000097 |
Identifier | Type | State | Issuer |
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1932125648 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103TC0700X | Psychologist - Clinical | 5883 (Ohio) | Primary |
Provider Name | Melanie Anne Bergsten |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1932140464 PECOS PAC ID: 3072560895 Enrollment ID: I20050407000183 |
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