Provider Demographics
NPI:1861845083
Name:BLUE SKY COUNSELING
Entity Type:Organization
Organization Name:BLUE SKY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HERON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:307-851-3955
Mailing Address - Street 1:625 E MADISON AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:RIVERTON
Mailing Address - State:WY
Mailing Address - Zip Code:82501-4712
Mailing Address - Country:US
Mailing Address - Phone:307-851-3955
Mailing Address - Fax:
Practice Address - Street 1:1018 EASTVIEW DR
Practice Address - Street 2:
Practice Address - City:RIVERTON
Practice Address - State:WY
Practice Address - Zip Code:82501-2616
Practice Address - Country:US
Practice Address - Phone:307-851-3955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-22
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLCSW251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management