Provider Demographics
NPI:1992017016
Name:JOURNEY 2 EMPOWER CONSULTING
Entity Type:Organization
Organization Name:JOURNEY 2 EMPOWER CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:OTERO
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:786-253-5480
Mailing Address - Street 1:12054 SW 116TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-5104
Mailing Address - Country:US
Mailing Address - Phone:786-253-5480
Mailing Address - Fax:305-595-4088
Practice Address - Street 1:12054 SW 116TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-5104
Practice Address - Country:US
Practice Address - Phone:786-253-5480
Practice Address - Fax:305-595-4088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-06
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9657101YM0800X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH9657OtherMENTAL HEALTH LICENSE