Healthcare Provider Details

I. General information

NPI: 1265086870
Provider Name (Legal Business Name): BLUE SKIES COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2019
Last Update Date: 07/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4308 CARLISLE BLVD NE STE 206
ALBUQUERQUE NM
87107-4849
US

IV. Provider business mailing address

PO BOX 93096
ALBUQUERQUE NM
87199-3096
US

V. Phone/Fax

Practice location:
  • Phone: 505-306-3248
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ALESSANDRA CALHOUN
Title or Position: OWNER
Credential:
Phone: 505-306-3248