Provider Demographics
NPI:1437718822
Name:OUTER BANKS INNER JOURNEY
Entity Type:Organization
Organization Name:OUTER BANKS INNER JOURNEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:FAYE
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:252-207-3837
Mailing Address - Street 1:1504 CAPTAINS LN
Mailing Address - Street 2:
Mailing Address - City:KILL DEVIL HILLS
Mailing Address - State:NC
Mailing Address - Zip Code:27948-9462
Mailing Address - Country:US
Mailing Address - Phone:252-207-3837
Mailing Address - Fax:252-255-0787
Practice Address - Street 1:2224 S CROATAN HWY UNIT D
Practice Address - Street 2:
Practice Address - City:NAGS HEAD
Practice Address - State:NC
Practice Address - Zip Code:27959-8813
Practice Address - Country:US
Practice Address - Phone:252-207-3837
Practice Address - Fax:252-255-0787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty