Provider Demographics
NPI:1588246870
Name:NIGHT SKY COUNSELING LLC
Entity type:Organization
Organization Name:NIGHT SKY COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:R
Authorized Official - Last Name:MOONEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:207-458-1665
Mailing Address - Street 1:79 LANCASTER RD
Mailing Address - Street 2:
Mailing Address - City:PITTSTON
Mailing Address - State:ME
Mailing Address - Zip Code:04345-5970
Mailing Address - Country:US
Mailing Address - Phone:207-458-1665
Mailing Address - Fax:
Practice Address - Street 1:79 LANCASTER RD
Practice Address - Street 2:
Practice Address - City:PITTSTON
Practice Address - State:ME
Practice Address - Zip Code:04345-5970
Practice Address - Country:US
Practice Address - Phone:207-458-1665
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-26
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty