Organization
SKYEIA HOLISTIC SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISA M CARRICO LCPC (CEO)
(240) 321-2487
Entity
Organization
Contact information
Practice address
315 DAWSON AVE STE C, OAKLAND, MD 21550-5113
(240) 321-2487
(301) 334-5922
Mailing address
1138 EAGLE ROCK RD, OAKLAND, MD 21550-6825
(240) 321-2487
(301) 334-5922
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC1331
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012466400
—
MD
Enumeration date
04/14/2008
Last updated
12/16/2010
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