Provider Demographics
NPI:1194825273
Name:SKYE, KRYSE S (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KRYSE
Middle Name:S
Last Name:SKYE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT
Mailing Address - Street 2:PO BOX 7291
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04243-7291
Mailing Address - Country:US
Mailing Address - Phone:207-777-8950
Mailing Address - Fax:207-777-8800
Practice Address - Street 1:100 CAMPUS AVE STE A&B
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-6040
Practice Address - Country:US
Practice Address - Phone:207-755-3434
Practice Address - Fax:207-755-3474
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEME298984101YM0800X
MELC104681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health