NPIMap

Organization Active NPI

Blue Sky Behavior Therapy

  • Behavior Analyst
  • Ridgeland, MS
National Provider Identifier
1609418896
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
BLUE SKY BEHAVIOR THERAPY
Practice address
402B Legacy Park
Ridgeland, MS 39157-4315
Phone
(769) 233-7154
NPI assigned
Oct 9, 2019
Last updated
Sep 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Neelima Gutti DuncanNPI 1942571864
Title
Clinic Director
Phone
(769) 233-7154

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193400000X SINGLE SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

402B Legacy Park
Ridgeland, MS 39157-4315

Mailing address

402B Legacy Park
Ridgeland, MS 39157-4315
Phone (769) 233-7154

National Provider Directory

National Provider Directory

Locations

402B Legacy Park
Ridgeland, MS 39157

Practitioners & affiliated clinicians

Practitioners 56

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 56

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1570579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632268800000",
    "number": "1609418896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402B LEGACY PARK",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391574315",
            "telephone_number": "769-233-7154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402B LEGACY PARK",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391574315",
            "telephone_number": "769-233-7154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE SKY BEHAVIOR THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-09",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A",
        "authorized_official_last_name": "DUNCAN",
        "authorized_official_first_name": "NEELIMA",
        "authorized_official_middle_name": "GUTTI",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "769-233-7154"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.