MEDICARE: CLEAR SKIES THERAPY CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1174237044
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEAR SKIES THERAPY CENTER

Provider Business Mailing Address
First Line	:	13477 W BLUEBONNET DR
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83713-1341
Country	:	US
Telephone Number	:	208-254-1112
Fax Number	:

Provider Business Practice Location Address
First Line	:	13477 W BLUEBONNET DR
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83713-1341
Country	:	US
Telephone Number	:	208-254-1112
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MELISSA KOHLER
Credential	:	LCPC
Telephone Number	:	208-254-1112

Provider Enumeration Date	:	01/05/2023
Last Update Date	:	12/16/2025

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Directions to “CLEAR SKIES THERAPY CENTER ” Practice Location

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