Provider Demographics
NPI:1740783265
Name:COMMITTED TO THE JOURNEY LLC
Entity Type:Organization
Organization Name:COMMITTED TO THE JOURNEY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SEMIKAH
Authorized Official - Middle Name:
Authorized Official - Last Name:YISRAEL-JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCMFT
Authorized Official - Phone:202-681-5226
Mailing Address - Street 1:12138 CENTRAL AVE STE 145
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-1910
Mailing Address - Country:US
Mailing Address - Phone:202-681-5226
Mailing Address - Fax:
Practice Address - Street 1:1400 MERCANTILE LN STE 208
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-5350
Practice Address - Country:US
Practice Address - Phone:202-681-5226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-11
Last Update Date:2018-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLCM657101YM0800X, 106H00000X, 261QM0850X
MDLGP7904101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Multi-Specialty