| Sunrise Children's Services, Inc. | |
|
300 Hope Street Mt. Washington KY 40047 | |
| (502) 538-1000 | |
| (502) 538-1100 |
| Full Name | Sunrise Children's Services, Inc. |
|---|---|
| Speciality | Counselor |
| Location | 300 Hope Street, Mt. Washington, Kentucky |
| Authorized Official Name and Position | Sharon C' De Baca (EXECUTIVE ASSISTANT TO PRESIDENT) |
| Authorized Official Contact | 5025381010 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunrise Children's Services, Inc. Po Box 1429 Mt Washington KY 40047-1429 Ph: (502) 538-1000 | Sunrise Children's Services, Inc. 300 Hope Street Mt. Washington KY 40047 Ph: (502) 538-1000 |
| NPI Number | 1992820849 |
|---|---|
| Provider Enumeration Date | 03/20/2007 |
| Last Update Date | 10/25/2022 |
| Certification Date | 10/25/2022 |
| Medicare PECOS PAC ID | 9335663780 |
|---|---|
| Medicare Enrollment ID | O20250408001043 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992820849 | NPI | - | NPPES |
| 7100326270 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Stephanie Faith Brewster |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013250489 PECOS PAC ID: 4880118132 Enrollment ID: I20250408001342 |
| Provider Name | Jennifer Booth Courtney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043608797 PECOS PAC ID: 6709300031 Enrollment ID: I20250408003588 |
| Provider Name | Valerie Lynn Crume |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528300084 PECOS PAC ID: 0345764684 Enrollment ID: I20250408003609 |