Provider Demographics
NPI:1043891088
Name:JOURNEY COUNSELING CENTER, LLC
Entity Type:Organization
Organization Name:JOURNEY COUNSELING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHALK
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:989-778-2323
Mailing Address - Street 1:4771 2 MILE RD STE A
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-2775
Mailing Address - Country:US
Mailing Address - Phone:989-778-2323
Mailing Address - Fax:989-778-2322
Practice Address - Street 1:4771 2 MILE RD STE A
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-2775
Practice Address - Country:US
Practice Address - Phone:989-778-2323
Practice Address - Fax:989-778-2322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-20
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty