Provider Demographics
NPI:1730671652
Name:CLEAR SKIES COUNSELING
Entity Type:Organization
Organization Name:CLEAR SKIES COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:S
Authorized Official - Last Name:MEVORAH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:917-620-4617
Mailing Address - Street 1:626C DEAL RD
Mailing Address - Street 2:
Mailing Address - City:MONROE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-7218
Mailing Address - Country:US
Mailing Address - Phone:917-620-4617
Mailing Address - Fax:
Practice Address - Street 1:70 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CRANBURY
Practice Address - State:NJ
Practice Address - Zip Code:08512-3140
Practice Address - Country:US
Practice Address - Phone:609-383-4050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-06
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC057366001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty