Organization
SUNRISE COUNSELING AND REHABILITATION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN GITTENS (DIRECTOR)
(718) 776-1017
Entity
Organization
Contact information
Practice address
11216 219TH ST, QUEENS VILLAGE, NY 11429-2640
(718) 776-1017
(775) 269-3969
Mailing address
11216 219TH ST, QUEENS VILLAGE, NY 11429-2640
(718) 776-1017
(775) 269-3969
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
103TP2701X
Group Psychotherapy Psychologist
—
—
103TR0400X
Rehabilitation Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
12/11/2013
Last updated
12/11/2013
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