| Sunrise Wellness, Llc | |
|
16201 90th St Ne Ste 203 Otsego MN 55330-7465 | |
| (763) 777-9499 | |
| (763) 373-9463 |
| Full Name | Sunrise Wellness, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 16201 90th St Ne Ste 203, Otsego, Minnesota |
| Authorized Official Name and Position | Andrea Hendel (OWNER/PSYCHOTHERAPIST) |
| Authorized Official Contact | 7637779499 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunrise Wellness, Llc 16201 90th St Ne Ste 203 Otsego MN 55330-7465 Ph: (763) 777-9499 | Sunrise Wellness, Llc 16201 90th St Ne Ste 203 Otsego MN 55330-7465 Ph: (763) 777-9499 |
| NPI Number | 1790309813 |
|---|---|
| Provider Enumeration Date | 06/04/2020 |
| Last Update Date | 12/19/2023 |
| Certification Date | 12/19/2023 |
| Medicare PECOS PAC ID | 7315390531 |
|---|---|
| Medicare Enrollment ID | O20240124001881 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790309813 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Brad W Houghton |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053528125 PECOS PAC ID: 9638356744 Enrollment ID: I20110526000496 |
| Provider Name | Deborah Ruyman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699217604 PECOS PAC ID: 4486919727 Enrollment ID: I20180607001056 |
| Provider Name | Michelle Lynn Rosenau |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1760843155 PECOS PAC ID: 5395194245 Enrollment ID: I20231228001906 |
| Provider Name | Andrea M Hendel |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1477626000 PECOS PAC ID: 3577916709 Enrollment ID: I20240124002586 |
| Provider Name | Ehlan Thompson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1881917110 PECOS PAC ID: 0749624310 Enrollment ID: I20240222001299 |
| Provider Name | Jessica E Schlieman |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1528526324 PECOS PAC ID: 1951745538 Enrollment ID: I20240222001586 |
| Provider Name | Jessica E Nelson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386267110 PECOS PAC ID: 7214374339 Enrollment ID: I20240326000534 |
Allsides Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 15248 72nd St Ne, Otsego, MN 55330 Phone: 817-891-8347 |