Healthcare Provider Details

I. General information

NPI: 1174237044
Provider Name (Legal Business Name): CLEAR SKIES THERAPY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2023
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13477 W BLUEBONNET DR
BOISE ID
83713-1341
US

IV. Provider business mailing address

13477 W BLUEBONNET DR
BOISE ID
83713-1341
US

V. Phone/Fax

Practice location:
  • Phone: 208-254-1112
  • Fax:
Mailing address:
  • Phone: 208-254-1112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MELISSA KOHLER
Title or Position: OWNER
Credential: LCPC
Phone: 208-254-1112