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General NPI Number Information
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NPI Number | 1053127399
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Entity Type | Organization
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Legal Business Name | BRIGHT SKY COUNSELING, PLLC
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Dates
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Enumeration Date | 12/10/2024
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 990 E SOUTH BLVD STE 250
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City | TROY
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State | MI
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Zip | 48085-1400
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Country | US
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Telephone | 947-222-5429
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Fax |
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Provider Business Mailing Address
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Address Line | 990 E SOUTH BLVD STE 250
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City | TROY
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State | MI
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Zip | 48085-1400
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Country | US
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Telephone | 947-222-5429
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Fax |
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Authorized Official
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Title or Position | CEO/CLINICAL PSYCHOTHERAPIST
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Name | MICHAEL MCKIDDY
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Credential | MA, LPC
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Telephone | 586-381-4020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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