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General NPI Number Information
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NPI Number | 1306136403
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Entity Type | Organization
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Legal Business Name | BLUE SKIES COUNSELING
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Dates
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Enumeration Date | 04/11/2011
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Last Update Date | 04/11/2011
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Provider Practice Location Address
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Address Line | 16161 HIGHWAY 280 SUITE 7
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City | CHELSEA
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State | AL
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Zip | 35043-8405
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Country | US
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Telephone | 205-381-2802
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Fax | 205-618-0191
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Provider Business Mailing Address
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Address Line | 1323 FARMINGDALE RD
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City | HARPERSVILLE
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State | AL
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Zip | 35078-5107
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Country | US
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Telephone | 205-381-2802
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Fax | 205-618-0191
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Authorized Official
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Title or Position | SOLE MBR
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Name | DAVID WELLINGTON STEVENS
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Credential | LCSW,PIP
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Telephone | 205-381-2802
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 0958-2166C
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License Number State | AL
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