MEDICARE: BLUE SKIES PSYCHIATRY, PLLC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1487518973
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLUE SKIES PSYCHIATRY, PLLC

Provider Business Mailing Address
First Line	:	16601 N 40TH ST STE 216
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-3354
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	16601 N 40TH ST STE 216
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-3354
Country	:	US
Telephone Number	:	314-335-9388
Fax Number	:

Authorized Official
Title or Position	:	MSN, APRN, PMHNP-C
Name	:	CARLY REINA
Credential	:	MSN, APRN, PMHNP-C
Telephone Number	:	314-335-9388

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	12/10/2025

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