Provider Demographics
NPI:1164039426
Name:ANNESCO'S JOURNEY LLC
Entity Type:Organization
Organization Name:ANNESCO'S JOURNEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER & CLINICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NAKEIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUDSON
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, MSW, LISW-S
Authorized Official - Phone:614-259-8879
Mailing Address - Street 1:200 E CAMPUS VIEW BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-4678
Mailing Address - Country:US
Mailing Address - Phone:614-259-8879
Mailing Address - Fax:614-413-1537
Practice Address - Street 1:200 E CAMPUS VIEW BLVD STE 200
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-4678
Practice Address - Country:US
Practice Address - Phone:614-259-8879
Practice Address - Fax:614-413-1537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty