Provider Demographics
NPI:1770296980
Name:QUIET SKY COUNSELING AZ LLC
Entity type:Organization
Organization Name:QUIET SKY COUNSELING AZ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:KAYCEE
Authorized Official - Middle Name:M
Authorized Official - Last Name:PITTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-637-8007
Mailing Address - Street 1:2717 N STEVES BLVD STE 11
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86004-3959
Mailing Address - Country:US
Mailing Address - Phone:928-487-1213
Mailing Address - Fax:
Practice Address - Street 1:2717 N STEVES BLVD STE 11
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86004-3959
Practice Address - Country:US
Practice Address - Phone:928-487-1213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)