Healthcare Provider Details

I. General information

NPI: 1154967057
Provider Name (Legal Business Name): BLUESKY TELEPSYCH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2019
Last Update Date: 11/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 SE MARTIN AVE
STUART FL
34996-1213
US

IV. Provider business mailing address

135 SE MARTIN AVE
STUART FL
34996-1213
US

V. Phone/Fax

Practice location:
  • Phone: 773-629-0716
  • Fax: 773-989-2781
Mailing address:
  • Phone: 773-629-0716
  • Fax: 773-989-2781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: RICHELLE STRAUSS
Title or Position: OWNER
Credential: MD
Phone: 773-989-2780