| Sunrise Psychological Services, Inc. | |
|
1717 Heritage Lake Dr Dayton OH 45458-6067 | |
| (614) 961-2203 | |
| Not Available |
| Full Name | Sunrise Psychological Services, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 1717 Heritage Lake Dr, Dayton, Ohio |
| Authorized Official Name and Position | Melanie Anne Bergsten (PRESIDENT) |
| Authorized Official Contact | 6149612203 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunrise Psychological Services, Inc. 1717 Heritage Lake Dr Dayton OH 45458-6067 Ph: (614) 961-2203 | Sunrise Psychological Services, Inc. 1717 Heritage Lake Dr Dayton OH 45458-6067 Ph: (614) 961-2203 |
| NPI Number | 1932125648 |
|---|---|
| Provider Enumeration Date | 07/14/2006 |
| Last Update Date | 12/01/2010 |
| Medicare PECOS PAC ID | 1456308279 |
|---|---|
| Medicare Enrollment ID | O20050405000097 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932125648 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 5883 (Ohio) | Primary |
| Provider Name | Melanie Anne Bergsten |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932140464 PECOS PAC ID: 3072560895 Enrollment ID: I20050407000183 |
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