Provider Demographics
NPI:1396442471
Name:JOURNEY MENTAL HEALTH, LLC
Entity type:Organization
Organization Name:JOURNEY MENTAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:316-350-5753
Mailing Address - Street 1:2426 N WOODRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-8202
Mailing Address - Country:US
Mailing Address - Phone:316-500-7610
Mailing Address - Fax:
Practice Address - Street 1:250 N ROCK RD STE 300G
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-2263
Practice Address - Country:US
Practice Address - Phone:316-500-7610
Practice Address - Fax:316-661-1523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-09
Last Update Date:2023-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty