Provider Demographics
NPI:1821771569
Name:JOURNEY 2 GROW THERAPY LLC
Entity Type:Organization
Organization Name:JOURNEY 2 GROW THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:EUNICE
Authorized Official - Middle Name:WONJOO
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:718-309-1999
Mailing Address - Street 1:23 HAMPTON CT.
Mailing Address - Street 2:ATTN: EUNICE LEE
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920
Mailing Address - Country:US
Mailing Address - Phone:718-309-1999
Mailing Address - Fax:
Practice Address - Street 1:55 S. FINLEY AVE.
Practice Address - Street 2:2ND FL, SUITE B
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920
Practice Address - Country:US
Practice Address - Phone:908-373-1079
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)