Provider Demographics
NPI:1003375338
Name:THE JOURNEY THERAPY LLC
Entity Type:Organization
Organization Name:THE JOURNEY THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BETHANY
Authorized Official - Middle Name:
Authorized Official - Last Name:CROWLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MFT, CEDS
Authorized Official - Phone:808-277-2273
Mailing Address - Street 1:515 ONEAWA ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2228
Mailing Address - Country:US
Mailing Address - Phone:808-277-2273
Mailing Address - Fax:866-278-4162
Practice Address - Street 1:328 ULUNIU ST STE 202
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2542
Practice Address - Country:US
Practice Address - Phone:808-277-2273
Practice Address - Fax:866-278-4162
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE JOURNEY THERAPY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-16
Last Update Date:2019-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI1710179833OtherHMSA