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General NPI Number Information
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NPI Number | 1407464589
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Entity Type | Organization
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Legal Business Name | BLUESKY TELEPSYCH, SC
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Dates
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Enumeration Date | 07/15/2020
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Last Update Date | 09/20/2022
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Provider Practice Location Address
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Address Line | 301 MCCULLOUGH DR
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City | CHARLOTTE
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State | NC
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Zip | 28262-3310
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Country | US
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Telephone | 773-629-0716
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Fax |
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Provider Business Mailing Address
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Address Line | RICHELLE STRAUSS 1431 OPUS PLACE, SUITE 110
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City | DOWNERS GROVE
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State | IL
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Zip | 60515
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Country | US
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Telephone | 888-279-0002
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RICHELLE STRAUSS
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Credential | MD
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Telephone | 773-629-0716
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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