Provider Demographics
NPI:1295580678
Name:POWERFUL JOURNEY HEALING
Entity type:Organization
Organization Name:POWERFUL JOURNEY HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:OLIVIA
Authorized Official - Last Name:JENNINGS- GIRAU
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:848-240-8249
Mailing Address - Street 1:22 WESTBROOK RD
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-2121
Mailing Address - Country:US
Mailing Address - Phone:848-240-8249
Mailing Address - Fax:
Practice Address - Street 1:22 WESTBROOK RD
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-2121
Practice Address - Country:US
Practice Address - Phone:848-240-8249
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-19
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)