Provider Demographics
NPI:1467708859
Name:JOURNEY TO WELLNESS BEHAVIORAL HEALTH SERVICES
Entity Type:Organization
Organization Name:JOURNEY TO WELLNESS BEHAVIORAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLEAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:919-723-0825
Mailing Address - Street 1:400 W MAIN ST
Mailing Address - Street 2:SUITE 403
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-3247
Mailing Address - Country:US
Mailing Address - Phone:919-723-0825
Mailing Address - Fax:
Practice Address - Street 1:400 WEST MAIN STREET
Practice Address - Street 2:SUITE 403
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701
Practice Address - Country:US
Practice Address - Phone:919-723-0825
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-03
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC006468101YM0800X
NCC004805101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty