NPIMap

Organization Active NPI

Sierra Sunrise Wellness Group, LLC

  • Marriage & Family Therapist
  • Reno, NV
National Provider Identifier
1629646849
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
SIERRA SUNRISE WELLNESS GROUP, LLC
Doing business as
Sierra Sunrise Wellness Group, LLC
Practice address
855 S Center St Ste 101
Reno, NV 89501-2332
Phone
(775) 440-1256
NPI assigned
Jun 14, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Authorized official

Name
Nora Brucklacher, LMFTNPI 1255701652
Title
Owner
Phone
(775) 224-0703

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

855 S Center St Ste 101
Reno, NV 89501-2332

Mailing address

855 S Center St Ste 101
Reno, NV 89501-2332
Phone (775) 440-1256

Other identifiers 1

IdentifierTypeStateIssuer
NV20131314685OtherNVNV BUSINESS ID

Other names 1

  • Sierra Sunrise Wellness Group, LLC Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ssws101@hushmail.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230731002382 NV Part B Supplier - Clinic/Group Practice 2062873524 Receives reassigned benefits from 6 practitioners
Practice locations: Reno, NV

National Provider Directory

National Provider Directory

Locations

855 S Center St
Ste 101
Reno, NV 89501
Phone (775) 440-1256

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623628800000",
    "number": "1629646849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 S CENTER ST STE 101",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895012332",
            "telephone_number": "775-440-1256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 S CENTER ST STE 101",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895012332",
            "telephone_number": "775-440-1256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIERRA SUNRISE WELLNESS GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-14",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A",
        "authorized_official_last_name": "BRUCKLACHER",
        "authorized_official_first_name": "NORA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "775-224-0703",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NV BUSINESS ID",
            "identifier": "NV20131314685",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ssws101@hushmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "855 S Center St Ste 101",
            "city": "Reno",
            "state": "NV",
            "country_code": "US",
            "postal_code": "895012332",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Sierra Sunrise Wellness Group, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reno, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; 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.