Provider Demographics
NPI:1043365521
Name:JOURNEYS A CENTER FOR PASTORAL PSYCHOTHERAPY & SPIRITUAL GROWTH
Entity Type:Organization
Organization Name:JOURNEYS A CENTER FOR PASTORAL PSYCHOTHERAPY & SPIRITUAL GROWTH
Other - Org Name:JOURNEYS PASTORAL COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:L
Authorized Official - Last Name:SUNDELL
Authorized Official - Suffix:
Authorized Official - Credentials:DMIN
Authorized Official - Phone:603-868-5166
Mailing Address - Street 1:PO BOX 684
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03824-0684
Mailing Address - Country:US
Mailing Address - Phone:603-886-5166
Mailing Address - Fax:603-868-8166
Practice Address - Street 1:1 PARK CT
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NH
Practice Address - Zip Code:03824-2407
Practice Address - Country:US
Practice Address - Phone:603-868-5166
Practice Address - Fax:603-868-8166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH45101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30006446Medicaid