Provider Demographics
NPI:1598260747
Name:JOURNEY COUNSELING CENTER, PLLC
Entity Type:Organization
Organization Name:JOURNEY COUNSELING CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHELDON
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:ADKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:405-642-6811
Mailing Address - Street 1:14013 SMITHURST RD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-7249
Mailing Address - Country:US
Mailing Address - Phone:405-642-6811
Mailing Address - Fax:
Practice Address - Street 1:2801 E MEMORIAL RD
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-6474
Practice Address - Country:US
Practice Address - Phone:405-642-6811
Practice Address - Fax:405-425-5251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-29
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1583101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty