Provider Demographics
NPI:1811495666
Name:CLEAR SKY COUNSELING, P.C.
Entity type:Organization
Organization Name:CLEAR SKY COUNSELING, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AGENT
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:S
Authorized Official - Last Name:DANN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:231-215-1608
Mailing Address - Street 1:PO BOX 712
Mailing Address - Street 2:
Mailing Address - City:KINGSLEY
Mailing Address - State:MI
Mailing Address - Zip Code:49649-0712
Mailing Address - Country:US
Mailing Address - Phone:231-818-7907
Mailing Address - Fax:
Practice Address - Street 1:2283 E M 113
Practice Address - Street 2:
Practice Address - City:KINGSLEY
Practice Address - State:MI
Practice Address - Zip Code:49649-9370
Practice Address - Country:US
Practice Address - Phone:231-818-7907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-26
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010589391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty