Provider Demographics
NPI:1083803464
Name:INTUITIVE JOURNEYS, PLC
Entity Type:Organization
Organization Name:INTUITIVE JOURNEYS, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIANNE
Authorized Official - Middle Name:REDMOND
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:703-862-5679
Mailing Address - Street 1:43 TOWN AND COUNTRY DR
Mailing Address - Street 2:143
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22405-8729
Mailing Address - Country:US
Mailing Address - Phone:703-862-5679
Mailing Address - Fax:540-310-4072
Practice Address - Street 1:1802 AUGUSTINE AVE
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4606
Practice Address - Country:US
Practice Address - Phone:703-862-5679
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040046041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
303185OtherSOUTHEAST
087841OtherSENTERA
307304 (IND 307305)OtherANTHEM
468354OtherVALUEOPTIONS
212387OtherVA
7305414OtherAETNA
3878OtherCAREFIRST BC
512389OtherNCPPO
3878OtherCAREFIRST BC
212387OtherVA