Provider Demographics
NPI:1184488348
Name:BLUE SKY MENTAL HEALTH LLC
Entity type:Organization
Organization Name:BLUE SKY MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCADOO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:570-637-0918
Mailing Address - Street 1:32 WATTS ST
Mailing Address - Street 2:
Mailing Address - City:TOWANDA
Mailing Address - State:PA
Mailing Address - Zip Code:18848-1324
Mailing Address - Country:US
Mailing Address - Phone:570-637-0918
Mailing Address - Fax:
Practice Address - Street 1:32 WATTS ST
Practice Address - Street 2:
Practice Address - City:TOWANDA
Practice Address - State:PA
Practice Address - Zip Code:18848-1324
Practice Address - Country:US
Practice Address - Phone:570-637-0918
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-08
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty