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NPI Code Detail

MEDICARE: BLUE SKIES COUNSELING LLC

MEDICARE: BLUE SKIES COUNSELING LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
21041C0700XClinical Social Worker

General Provider Information

NPI Number : 1184354177
Entity Type Code : Organization
Provider Name (Legal Business Name) : BLUE SKIES COUNSELING LLC
Provider Business Mailing Address
First Line : 1671 HOFFMAN RD STE 170
Second Line :
City : GREEN BAY
State : WI
Zip : 54311-6232
Country : US
Telephone Number : 920-288-2233
Fax Number : 920-486-9355
Provider Business Practice Location Address
First Line : 1671 HOFFMAN RD STE 170
Second Line :
City : GREEN BAY
State : WI
Zip : 54311-6232
Country : US
Telephone Number : 920-288-2233
Fax Number : 920-486-9355
Authorized Official
Title or Position : OWNER
Name : VANESSA BLANCHETTE
Credential : LCSW
Telephone Number : 920-288-2233
Provider Enumeration Date : 06/13/2022
Last Update Date : 12/08/2025

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