Provider Demographics
NPI:1528629565
Name:BLUE SKIES COUNSELING
Entity type:Organization
Organization Name:BLUE SKIES COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:SANTANA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:302-272-1206
Mailing Address - Street 1:438 TULLAMORE RD
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:DE
Mailing Address - Zip Code:19962-2600
Mailing Address - Country:US
Mailing Address - Phone:302-272-1206
Mailing Address - Fax:
Practice Address - Street 1:216 N RACE ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947-1409
Practice Address - Country:US
Practice Address - Phone:302-272-1206
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-20
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health