Provider Demographics
NPI:1710245543
Name:RESILIENT JOURNEYS, PLLC
Entity Type:Organization
Organization Name:RESILIENT JOURNEYS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW/LCAS
Authorized Official - Phone:828-376-0055
Mailing Address - Street 1:PO BOX 1426
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28793-1426
Mailing Address - Country:US
Mailing Address - Phone:828-376-0055
Mailing Address - Fax:828-376-0155
Practice Address - Street 1:220 3RD AVE W
Practice Address - Street 2:UNIT A
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-4330
Practice Address - Country:US
Practice Address - Phone:828-376-0055
Practice Address - Fax:828-376-0155
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-30
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1752101YA0400X
NCC0057941041C0700X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6008855Medicaid
NC6007035Medicaid