Provider Demographics
NPI:1770977654
Name:AUTUMN SKYE COUNSELING, LLC
Entity type:Organization
Organization Name:AUTUMN SKYE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:KULINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:303-847-7042
Mailing Address - Street 1:244 TIMBERLAKE RD
Mailing Address - Street 2:
Mailing Address - City:BOSTIC
Mailing Address - State:NC
Mailing Address - Zip Code:28018-4506
Mailing Address - Country:US
Mailing Address - Phone:303-847-7042
Mailing Address - Fax:303-458-5097
Practice Address - Street 1:244 TIMBERLAKE RD
Practice Address - Street 2:
Practice Address - City:BOSTIC
Practice Address - State:NC
Practice Address - Zip Code:28018-4506
Practice Address - Country:US
Practice Address - Phone:303-847-7042
Practice Address - Fax:303-458-5097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-27
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty