| Sunrise Supportive Counseling Llc | |
|
56 W Twin Oaks Ter Ste 3 South Burlington VT 05403-7138 | |
| (802) 227-2670 | |
| Not Available |
| Full Name | Sunrise Supportive Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 56 W Twin Oaks Ter Ste 3, South Burlington, Vermont |
| Authorized Official Name and Position | Kristi Cornforth (OWNER) |
| Authorized Official Contact | 8022272670 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunrise Supportive Counseling Llc Po Box 189 Colchester VT 05446-0189 Ph: (802) 227-2670 | Sunrise Supportive Counseling Llc 56 W Twin Oaks Ter Ste 3 South Burlington VT 05403-7138 Ph: (802) 227-2670 |
| NPI Number | 1366087488 |
|---|---|
| Provider Enumeration Date | 11/13/2019 |
| Last Update Date | 08/16/2023 |
| Certification Date | 08/16/2023 |
| Medicare PECOS PAC ID | 9931536679 |
|---|---|
| Medicare Enrollment ID | O20200219000886 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366087488 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kristi Cornforth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619433364 PECOS PAC ID: 2961741905 Enrollment ID: I20190308001078 |
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