Provider Demographics
NPI:1215522735
Name:SKYE FORENSIC MENTAL HEALTH CONSULTING, LLC
Entity type:Organization
Organization Name:SKYE FORENSIC MENTAL HEALTH CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COE / CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHANIEL
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:JR
Authorized Official - Credentials:PSYD
Authorized Official - Phone:408-373-0742
Mailing Address - Street 1:130 DESCANSO DR UNIT 333
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95134-1867
Mailing Address - Country:US
Mailing Address - Phone:408-373-0742
Mailing Address - Fax:
Practice Address - Street 1:2171 DARNIS CIR
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-3853
Practice Address - Country:US
Practice Address - Phone:408-373-0742
Practice Address - Fax:408-612-8798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensicGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Multi-Specialty