Provider Demographics
NPI:1942709290
Name:CLEAR SKY PSYCHOLOGICAL SERVICES LLC
Entity Type:Organization
Organization Name:CLEAR SKY PSYCHOLOGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:TERESA
Authorized Official - Last Name:SLODZINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:410-802-9109
Mailing Address - Street 1:901 FALLSCROFT WAY
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-1705
Mailing Address - Country:US
Mailing Address - Phone:410-802-9109
Mailing Address - Fax:443-681-7208
Practice Address - Street 1:222 BOSLEY AVE STE B2
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-4302
Practice Address - Country:US
Practice Address - Phone:410-802-9109
Practice Address - Fax:443-681-7208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-01
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03376103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty