Provider Demographics
NPI:1861278186
Name:SUNSHINE PSYCHIATRY LLC
Entity type:Organization
Organization Name:SUNSHINE PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:RETTSTATT
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:985-634-8509
Mailing Address - Street 1:30820 CARTER CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:LA
Mailing Address - Zip Code:70462
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:406 W MORRIS AVE
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-4150
Practice Address - Country:US
Practice Address - Phone:985-551-4948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-01
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2613022Medicaid
LA1467158618OtherNPI