Provider Demographics
NPI:1336468958
Name:JOURNEY TO FREEDOM
Entity Type:Organization
Organization Name:JOURNEY TO FREEDOM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MONTERO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:973-341-9869
Mailing Address - Street 1:555 PREAKNESS AVE
Mailing Address - Street 2:
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07502-1012
Mailing Address - Country:US
Mailing Address - Phone:973-341-9869
Mailing Address - Fax:
Practice Address - Street 1:555 PREAKNESS AVE
Practice Address - Street 2:
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07502-1012
Practice Address - Country:US
Practice Address - Phone:973-341-9869
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-21
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
NY004120-1101YM0800X
NJ37PC00359500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty