| Blue Sky Psychological Services Llc | |
| 
					2 Old North Rd Camden DE 19934-7100  | |
| (302) 943-3916 | |
| (833) 719-1246 | 
| Full Name | Blue Sky Psychological Services Llc | 
|---|---|
| Speciality | Community/Behavioral Health | 
| Location | 2 Old North Rd, Camden, Delaware | 
| Authorized Official Name and Position | Samantha Withrow (OWNER) | 
| Authorized Official Contact | 3029433916 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Blue Sky Psychological Services Llc 2 Old North Rd Po Box 1007 Camden DE 19934 Ph: (302) 943-3916  | Blue Sky Psychological Services Llc 2 Old North Rd Camden DE 19934-7100 Ph: (302) 943-3916  | 
| NPI Number | 1700491958 | 
|---|---|
| Provider Enumeration Date | 09/14/2020 | 
| Last Update Date | 09/14/2020 | 
| Certification Date | 09/14/2020 | 
| Medicare PECOS PAC ID | 3173935624 | 
|---|---|
| Medicare Enrollment ID | O20201208000304 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1700491958 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary | 
| Provider Name | Samantha L Withrow | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1346789369 PECOS PAC ID: 5799062691 Enrollment ID: I20170502001634  | 
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