Provider Demographics
NPI:1235481201
Name:JOURNEYS COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:JOURNEYS COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:L
Authorized Official - Last Name:OTERO-ARMIJO
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:505-715-7541
Mailing Address - Street 1:111 GOLD AVE SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-3430
Mailing Address - Country:US
Mailing Address - Phone:505-715-7541
Mailing Address - Fax:
Practice Address - Street 1:111 GOLD AVE SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-3430
Practice Address - Country:US
Practice Address - Phone:505-715-7541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0136091101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty