| Blue Sky Mind Llc | |
|
39 S Main St Ste 4 Clarkston MI 48346-1593 | |
| (313) 473-0150 | |
| (313) 490-3180 |
| Full Name | Blue Sky Mind Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 39 S Main St Ste 4, Clarkston, Michigan |
| Authorized Official Name and Position | Megan Gougeon (AUTHORIZED AGENT) |
| Authorized Official Contact | 3134730150 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Sky Mind Llc 39 S Main St Ste 4 Clarkston MI 48346-1593 Ph: (313) 473-0150 | Blue Sky Mind Llc 39 S Main St Ste 4 Clarkston MI 48346-1593 Ph: (313) 473-0150 |
| NPI Number | 1427853662 |
|---|---|
| Provider Enumeration Date | 02/13/2025 |
| Last Update Date | 04/07/2025 |
| Certification Date | 04/07/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427853662 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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