Provider Demographics
NPI:1356014120
Name:JOURNEY TO JOURNEY THERAPY SERVICES, PLLC
Entity Type:Organization
Organization Name:JOURNEY TO JOURNEY THERAPY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:PORSCHA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:708-620-3904
Mailing Address - Street 1:10228 E NORTHWEST HWY # 1093
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-4408
Mailing Address - Country:US
Mailing Address - Phone:708-620-3904
Mailing Address - Fax:
Practice Address - Street 1:10228 E NORTHWEST HWY # 1093
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238-4408
Practice Address - Country:US
Practice Address - Phone:708-620-3904
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-28
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty