Provider Demographics
NPI:1457820508
Name:JOURNEY COUNSELING SERVICES, PLLC
Entity Type:Organization
Organization Name:JOURNEY COUNSELING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAMACHE
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW, MLADC
Authorized Official - Phone:603-777-0361
Mailing Address - Street 1:1193 HOOKSETT RD STE 2
Mailing Address - Street 2:
Mailing Address - City:HOOKSETT
Mailing Address - State:NH
Mailing Address - Zip Code:03106-1091
Mailing Address - Country:US
Mailing Address - Phone:603-777-0361
Mailing Address - Fax:603-413-4633
Practice Address - Street 1:1193 HOOKSETT RD STE 2
Practice Address - Street 2:
Practice Address - City:HOOKSETT
Practice Address - State:NH
Practice Address - Zip Code:03106-1091
Practice Address - Country:US
Practice Address - Phone:603-777-0361
Practice Address - Fax:603-413-4633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-19
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH1003066465OtherNPI