Provider Demographics
NPI:1235566860
Name:JOURNEY TO SELF UNDERSTANDING
Entity Type:Organization
Organization Name:JOURNEY TO SELF UNDERSTANDING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:NYANG
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:240-403-4036
Mailing Address - Street 1:1 RESEARCH CT STE 450
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-6252
Mailing Address - Country:US
Mailing Address - Phone:240-403-4036
Mailing Address - Fax:304-565-8817
Practice Address - Street 1:1 RESEARCH CT STE 450
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6252
Practice Address - Country:US
Practice Address - Phone:240-403-4036
Practice Address - Fax:304-565-8817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCPC2684101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty