Provider Demographics
NPI:1235431677
Name:JOURNEY COUNSELING, LLC
Entity Type:Organization
Organization Name:JOURNEY COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:STONE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT
Authorized Official - Phone:575-682-8178
Mailing Address - Street 1:PO BOX 201
Mailing Address - Street 2:
Mailing Address - City:HIGH ROLLS
Mailing Address - State:NM
Mailing Address - Zip Code:88325-0201
Mailing Address - Country:US
Mailing Address - Phone:575-682-8178
Mailing Address - Fax:
Practice Address - Street 1:#1 OLD RAILROAD DRIVE
Practice Address - Street 2:
Practice Address - City:HIGH ROLLS
Practice Address - State:NM
Practice Address - Zip Code:88325
Practice Address - Country:US
Practice Address - Phone:575-682-8178
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-17
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0093371106H00000X
NM0115601106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty