| Blue Skies Mindfulness & Wellness, Llc | |
|
4416 Whitmoor Drive Evansville IN 47714 | |
| (812) 418-3986 | |
| (812) 636-1333 |
| Full Name | Blue Skies Mindfulness & Wellness, Llc |
|---|---|
| Speciality | Counselor |
| Location | 4416 Whitmoor Drive, Evansville, Indiana |
| Authorized Official Name and Position | Lori Anne Riley (TIN OWNER) |
| Authorized Official Contact | 8126047718 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Skies Mindfulness & Wellness, Llc Po Box 5471 Evansville IN 47716-0000 Ph: (812) 418-3986 | Blue Skies Mindfulness & Wellness, Llc 4416 Whitmoor Drive Evansville IN 47714 Ph: (812) 418-3986 |
| NPI Number | 1952959363 |
|---|---|
| Provider Enumeration Date | 08/28/2019 |
| Last Update Date | 08/06/2021 |
| Certification Date | 08/06/2021 |
| Medicare PECOS PAC ID | 3678905296 |
|---|---|
| Medicare Enrollment ID | O20191119002311 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952959363 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| Provider Name | Lori Anne Riley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366695637 PECOS PAC ID: 9830315183 Enrollment ID: I20170925001161 |
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