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General NPI Number Information
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NPI Number | 1750533113
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Entity Type | Organization
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Legal Business Name | CLEAR SKY COUNSELING AND CONSULTING
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Dates
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Enumeration Date | 10/16/2008
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Last Update Date | 10/16/2008
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Provider Practice Location Address
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Address Line | 703 MAPLE ST
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City | CHADRON
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State | NE
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Zip | 69337-2528
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Country | US
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Telephone | 308-430-3918
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Fax | 308-432-4327
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Provider Business Mailing Address
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Address Line | 703 MAPLE ST
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City | CHADRON
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State | NE
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Zip | 69337-2528
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Country | US
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Telephone | 308-430-3918
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Fax | 308-432-4327
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DEDE FARRAR
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Credential | MA, MFA, PLMHP
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Telephone | 308-430-3918
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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 | 8341
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License Number State | NE
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