Big Sky Mind, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

BIG SKY MIND, LLC

Doing business as

Adam Klaybor, LCSW

Practice address

15073 Shady Palms LN
Nokomis, FL 34275-4340

Phone

(541) 668-6678

NPI assigned

Sep 22, 2021

Last updated

Apr 22, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Adam Klaybor, LCSWNPI 1750853453

Title

Owner

Phone

(541) 668-6678

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Adam Klaybor, LCSW Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Locations

Practitioners 1

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.

• Adam Klaybor, LCSW

  • Clinical Social Worker
  • Bend, OR
  • NPI 1750853453
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1632268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745280000000",
    "number": "1699446450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15073 SHADY PALMS LN",
            "city": "NOKOMIS",
            "state": "FL",
            "postal_code": "342754340",
            "telephone_number": "541-668-6678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15073 SHADY PALMS LN",
            "city": "NOKOMIS",
            "state": "FL",
            "postal_code": "342754340",
            "telephone_number": "541-668-6678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIG SKY MIND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-22",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A",
        "authorized_official_last_name": "KLAYBOR",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-668-6678",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500794020",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adam Klaybor, LCSW",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Adam Klaybor, LCSW",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Nokomis, FL
• Providers in Nokomis, FL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.