Provider Demographics
NPI:1790395044
Name:SUNBIRD COUNSELING & CONSULTING LLC
Entity type:Organization
Organization Name:SUNBIRD COUNSELING & CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER & PSYCHOTHERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MINA
Authorized Official - Middle Name:LANI
Authorized Official - Last Name:BEVENEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCSW, MSW, MED
Authorized Official - Phone:484-361-4611
Mailing Address - Street 1:8 THE GREEN, SUITE 8392
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901
Mailing Address - Country:US
Mailing Address - Phone:484-361-4611
Mailing Address - Fax:
Practice Address - Street 1:8 THE GREEN, SUITE 8392
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901
Practice Address - Country:US
Practice Address - Phone:484-361-4611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-03
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE004547975Medicaid