Provider Demographics
NPI:1891181871
Name:BLUE SKIES COUNSELING SERVICE PLLC
Entity Type:Organization
Organization Name:BLUE SKIES COUNSELING SERVICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:252-714-7889
Mailing Address - Street 1:2404 CHARLES BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5901
Mailing Address - Country:US
Mailing Address - Phone:252-714-7889
Mailing Address - Fax:252-689-6178
Practice Address - Street 1:2404 CHARLES BLVD STE E
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5901
Practice Address - Country:US
Practice Address - Phone:252-714-7889
Practice Address - Fax:252-689-6178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3092101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty