NPIMap

Organization Active NPI

Sunrise Collaborative, LLC.

  • Clinical Social Worker
  • Warren, PA
National Provider Identifier
1023553369
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SUNRISE COLLABORATIVE, LLC.
Practice address
1048 Pennsylvania Ave W
Warren, PA 16365-1838
Phone
(724) 422-3928
Fax
(814) 313-1075
NPI assigned
Dec 22, 2016
Last updated
Oct 6, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Michael Richard Philhower, MSW, LCSWNPI 1790964260
Title
Owner/Licensed Clinical Social Work
Phone
(724) 422-3928

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU
Professional Counselor 101YP2500X NU
Clinical Social Worker 1041C0700X CW017135 PA
Clinical Social Worker 1041C0700X NU Primary
Psychiatry Physician 2084P0800X NU

Addresses

Primary practice location

1048 Pennsylvania Ave W
Warren, PA 16365-1838

Mailing address

1048 Pennsylvania Ave W
Warren, PA 16365-1838
Phone (814) 230-9111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190326000568 PA Part B Supplier - Clinic/Group Practice 9739429994 Receives reassigned benefits from 9 practitioners
Practice locations: Warren, PA

National Provider Directory

National Provider Directory

Locations

115 Pennsylvania Ave W
Ste B
Warren, PA 16365
Phone (724) 422-3928

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1482364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601942400000",
    "number": "1023553369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1048 PENNSYLVANIA AVE W",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163651838",
            "telephone_number": "814-230-9111",
            "fax_number": "814-313-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1048 PENNSYLVANIA AVE W",
            "city": "WARREN",
            "state": "PA",
            "postal_code": "163651838",
            "telephone_number": "724-422-3928",
            "fax_number": "814-313-1075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE COLLABORATIVE, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-22",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A",
        "authorized_official_last_name": "PHILHOWER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER/LICENSED CLINICAL SOCIAL WORK",
        "authorized_official_telephone_number": "724-422-3928",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW017135",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.