MEDICARE: CLEAR SKY MENTAL HEALTH AND WELLNESS, LLC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1962345215
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEAR SKY MENTAL HEALTH AND WELLNESS, LLC

Provider Business Mailing Address
First Line	:	163 CAPRON FARM DR
Second Line	:
City	:	WARWICK
State	:	RI
Zip	:	02886-7700
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	390 TOLL GATE RD STE 206
Second Line	:
City	:	WARWICK
State	:	RI
Zip	:	02886-4351
Country	:	US
Telephone Number	:	401-293-8332
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SANTINA SALERNO
Credential	:	APRN
Telephone Number	:	207-837-9622

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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