Organization
SUNRISE PSYCHOLOGICAL SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CONSTANCE ARIA PH.D. (PRESIDENT)
(239) 280-6061
Entity
Organization
Contact information
Practice address
950 N COLLIER BLVD FL 4, MARCO ISLAND, FL 34145-2725
(239) 280-6061
Mailing address
14398 MANCHESTER DR, NAPLES, FL 34114-8626
(239) 280-6061
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY3245
FL
103TA0400X
Addiction (Substance Use Disorder) Psychologist
PY3245
FL
103TA0700X
Adult Development & Aging Psychologist
PY3245
FL
103TB0200X
Cognitive & Behavioral Psychologist
PY3245
FL
103TC0700X
Clinical Psychologist
PY3245
FL
103TC2200X
Clinical Child & Adolescent Psychologist
PY3245
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
75280
BLUE CROSS BLUE SHIELD
FL
Enumeration date
09/22/2006
Last updated
10/29/2019
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