Provider Demographics
NPI:1710431689
Name:SKY WITNESS HEALING ARTS LLC
Entity Type:Organization
Organization Name:SKY WITNESS HEALING ARTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTITIONER, OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRANDICE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNABEL
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LISW-S
Authorized Official - Phone:330-510-4921
Mailing Address - Street 1:PO BOX 3051
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-8051
Mailing Address - Country:US
Mailing Address - Phone:330-510-4921
Mailing Address - Fax:
Practice Address - Street 1:6263 FRANK AVE NW
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-7227
Practice Address - Country:US
Practice Address - Phone:330-510-4921
Practice Address - Fax:844-308-5812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-09
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.1100032.SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty