Provider Demographics
NPI:1629785688
Name:A JOURNEY FORWARD
Entity Type:Organization
Organization Name:A JOURNEY FORWARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRERA
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:951-515-9235
Mailing Address - Street 1:108 CADET CT
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-9008
Mailing Address - Country:US
Mailing Address - Phone:951-515-9235
Mailing Address - Fax:
Practice Address - Street 1:108 CADET CT
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-9008
Practice Address - Country:US
Practice Address - Phone:951-515-9235
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)