Provider Demographics
NPI:1801213541
Name:JOURNEY COUNSELING SERVICES
Entity Type:Organization
Organization Name:JOURNEY COUNSELING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:405-343-3664
Mailing Address - Street 1:4835 S PEORIA AVE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-4562
Mailing Address - Country:US
Mailing Address - Phone:405-343-3664
Mailing Address - Fax:
Practice Address - Street 1:4835 S PEORIA AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-4562
Practice Address - Country:US
Practice Address - Phone:405-343-3664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-19
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK082960571101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty