Provider Demographics
NPI:1821011545
Name:JOURNEY POINTS THERAPY SERVICES
Entity Type:Organization
Organization Name:JOURNEY POINTS THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:JO WEBER
Authorized Official - Last Name:SEDLAK
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:715-247-2802
Mailing Address - Street 1:PO BOX 217
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:WI
Mailing Address - Zip Code:54025-0217
Mailing Address - Country:US
Mailing Address - Phone:715-247-2802
Mailing Address - Fax:715-247-2802
Practice Address - Street 1:204 3RD AVE
Practice Address - Street 2:SUITE 110
Practice Address - City:OSCEOLA
Practice Address - State:WI
Practice Address - Zip Code:54020
Practice Address - Country:US
Practice Address - Phone:715-294-3567
Practice Address - Fax:715-247-2802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-25
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI660-124106H00000X
MN660-124251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI81583378018OtherANTHEM BLUE CROSS
MN506SOJ0OtherBLUE CROSS BLUE SHIELD
WIHP37568OtherHEALTH PARTNERS PROVIDER
WI50064-01OtherBHP PROVIDER