Provider Demographics
NPI:1619226362
Name:PERSONAL JOURNEYS COUNSELING
Entity Type:Organization
Organization Name:PERSONAL JOURNEYS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:EVE
Authorized Official - Last Name:GAGLIARDI
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:315-854-0441
Mailing Address - Street 1:PO BOX 255
Mailing Address - Street 2:424 JUDSON STREET ROAD
Mailing Address - City:CANTON
Mailing Address - State:NY
Mailing Address - Zip Code:13617-0255
Mailing Address - Country:US
Mailing Address - Phone:315-854-0441
Mailing Address - Fax:
Practice Address - Street 1:424 JUDSON STREET RD
Practice Address - Street 2:PERSONAL JOURNEYS COUNSELING
Practice Address - City:CANTON
Practice Address - State:NY
Practice Address - Zip Code:13617-3947
Practice Address - Country:US
Practice Address - Phone:315-854-0441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-07
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty