Provider Demographics
NPI:1669688388
Name:SKY, VERA C (LICSW)
Entity Type:Individual
Prefix:
First Name:VERA
Middle Name:C
Last Name:SKY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4110 INGOMAR ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-1946
Mailing Address - Country:US
Mailing Address - Phone:202-362-3351
Mailing Address - Fax:
Practice Address - Street 1:500 23RD ST NW
Practice Address - Street 2:SUITE 102
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-2828
Practice Address - Country:US
Practice Address - Phone:202-362-3351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3026671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0516OtherBLUE CROSS BLUE SHIELD
DC0516OtherBLUE CROSS BLUE SHIELD
DC0516OtherBLUE CROSS BLUE SHIELD