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General NPI Number Information
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NPI Number | 1063021228
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Entity Type | Organization
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Legal Business Name | CLEAR SKY THERAPY SERVICES LLC
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Dates
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Enumeration Date | 07/23/2020
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 3 BARNARD LN STE 311
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City | BLOOMFIELD
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State | CT
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Zip | 06002-2495
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Country | US
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Telephone | 860-458-4759
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 370236
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City | WEST HARTFORD
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State | CT
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Zip | 06137-0236
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. SEQUILLA CARTER
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Credential | DNP, MBA
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Telephone | 860-458-4759
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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