Provider Demographics
NPI:1104378975
Name:FORWARD JOURNEY PLLC
Entity Type:Organization
Organization Name:FORWARD JOURNEY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:919-633-7640
Mailing Address - Street 1:322 MILBURN LANDING CIR
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:NC
Mailing Address - Zip Code:27529-5996
Mailing Address - Country:US
Mailing Address - Phone:919-633-7640
Mailing Address - Fax:
Practice Address - Street 1:205 E DAVIS ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-5987
Practice Address - Country:US
Practice Address - Phone:919-633-7640
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-27
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty