# SUNRISE COUNSELING AND REHABILITATION SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386075711
- **Authorized official:** BRIAN GITTENS (DIRECTOR)
- **Authorized official phone:** (718) 776-1017

## Contact information

- **Practice address:** 11216 219TH ST, QUEENS VILLAGE, NY 11429-2640
- **Practice address phone:** (718) 776-1017
- **Practice address fax:** (775) 269-3969
- **Mailing address:** 11216 219TH ST, QUEENS VILLAGE, NY 11429-2640
- **Mailing address phone:** (718) 776-1017
- **Mailing address fax:** (775) 269-3969

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101Y00000X | Counselor | — | NULL | — |
| 101Y00000X | Counselor | — | — | — |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 103TA0400X | Addiction (Substance Use Disorder) Psychologist | — | NULL | — |
| 103TA0400X | Addiction (Substance Use Disorder) Psychologist | — | — | — |
| 103TC1900X | Counseling Psychologist | — | NULL | — |
| 103TC1900X | Counseling Psychologist | — | — | — |
| 103TP2701X | Group Psychotherapy Psychologist | — | NULL | — |
| 103TP2701X | Group Psychotherapy Psychologist | — | — | — |
| 103TR0400X | Rehabilitation Psychologist | — | NULL | — |
| 103TR0400X | Rehabilitation Psychologist | — | — | — |
| 104100000X | Social Worker | — | NULL | — |
| 104100000X | Social Worker | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |

## Other

- **Enumeration date:** 12/11/2013
- **Last updated:** 12/11/2013