Provider Demographics
NPI:1518480003
Name:OUTREACH JOURNEY COUNSELING PLLC
Entity Type:Organization
Organization Name:OUTREACH JOURNEY COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRIS
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:BARTON
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW, LCAS-A
Authorized Official - Phone:954-541-6880
Mailing Address - Street 1:7878 US HIGHWAY 74 W
Mailing Address - Street 2:
Mailing Address - City:ROWLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28383-8913
Mailing Address - Country:US
Mailing Address - Phone:954-541-6880
Mailing Address - Fax:
Practice Address - Street 1:402 HARRIS AVE
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-3112
Practice Address - Country:US
Practice Address - Phone:954-541-6880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-17
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0109311041C0700X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty