MEDICARE: SKYE COUNSELING, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	101YA0400X	Addiction (Substance Use Disorder) Counselor
3	101YM0800X	Mental Health Counselor
4	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1386152577
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SKYE COUNSELING, LLC

Provider Business Mailing Address
First Line	:	2950 E FLAMINGO RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-5209
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2950 E FLAMINGO RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-5209
Country	:	US
Telephone Number	:	702-930-9383
Fax Number	:

Authorized Official
Title or Position	:	COUNSELOR
Name	:	JENNIFER HOWE
Credential	:	LADC
Telephone Number	:	702-930-9383

Provider Enumeration Date	:	01/22/2018
Last Update Date	:	01/22/2018

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