Provider Demographics
NPI:1760142491
Name:BLUE SKIES COUNSELING, PLLC
Entity type:Organization
Organization Name:BLUE SKIES COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:LEA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LAFAVE
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:270-307-8089
Mailing Address - Street 1:4000 N DIXIE HWY STE 4
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-4650
Mailing Address - Country:US
Mailing Address - Phone:270-982-1555
Mailing Address - Fax:270-982-1559
Practice Address - Street 1:4000 N DIXIE HWY STE 4
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-4650
Practice Address - Country:US
Practice Address - Phone:270-982-1555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-21
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1405192043Medicaid