Provider Demographics
NPI:1992397673
Name:MEANINGFUL JOURNEYS THERAPY AND SUPPORT CENTER
Entity Type:Organization
Organization Name:MEANINGFUL JOURNEYS THERAPY AND SUPPORT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:870-495-2911
Mailing Address - Street 1:723 W KINGSHIGHWAY
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-5930
Mailing Address - Country:US
Mailing Address - Phone:870-495-2911
Mailing Address - Fax:
Practice Address - Street 1:723 W KINGSHIGHWAY
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-5930
Practice Address - Country:US
Practice Address - Phone:870-495-2911
Practice Address - Fax:870-495-2912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-04
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty