Healthcare Provider Details

I. General information

NPI: 1649006891
Provider Name (Legal Business Name): CLEAR SKIES PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2024
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16216 BAXTER RD STE 330
CHESTERFIELD MO
63017-4778
US

IV. Provider business mailing address

124 RUE GRAND DR
LAKE SAINT LOUIS MO
63367-1715
US

V. Phone/Fax

Practice location:
  • Phone: 573-321-5046
  • Fax:
Mailing address:
  • Phone: 573-321-5046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY HARVIN
Title or Position: OWNER/PSYCHIATRIST
Credential: MD
Phone: 573-321-5046