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General NPI Number Information
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NPI Number | 1730671652
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Entity Type | Organization
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Legal Business Name | CLEAR SKIES COUNSELING
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Dates
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Enumeration Date | 06/06/2018
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Last Update Date | 01/10/2020
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Provider Practice Location Address
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Address Line | 70 S MAIN ST
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City | CRANBURY
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State | NJ
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Zip | 08512-3140
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Country | US
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Telephone | 609-383-4050
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Fax |
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Provider Business Mailing Address
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Address Line | 626C DEAL RD
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City | MONROE TOWNSHIP
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State | NJ
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Zip | 08831-7218
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Country | US
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Telephone | 917-620-4617
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | BRENDA S MEVORAH
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Credential | LCSW
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Telephone | 917-620-4617
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05736600
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License Number State | NJ
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