=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407760010
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BLUE SKY COUNSELING & CO. LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/30/2026
-----------------------------------------------------
Last Update Date | 09/30/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1315 DAWNWOOD DR
-----------------------------------------------------
City | PARMA
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44134-3262
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-770-5662
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 46 SHOPPING PLZ # 1017
-----------------------------------------------------
City | CHAGRIN FALLS
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44022-3022
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-770-5662
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CO-OWNER/THERAPIST
-----------------------------------------------------
Name | PAIGE ROBERTSON
-----------------------------------------------------
Credential | MA, LPCC-S
-----------------------------------------------------
Telephone | 216-770-5662
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------