Provider Demographics
NPI:1700621893
Name:JOURNEY MENTAL HEALTH LLC
Entity type:Organization
Organization Name:JOURNEY MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:KAITLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:STEFFEN
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, APRN, PMHNP
Authorized Official - Phone:971-715-0754
Mailing Address - Street 1:5331 S MACADAM AVE
Mailing Address - Street 2:STE 258 #1015
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239
Mailing Address - Country:US
Mailing Address - Phone:971-715-0754
Mailing Address - Fax:971-206-9686
Practice Address - Street 1:6901 SE LAKE RD STE 27
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97267-2195
Practice Address - Country:US
Practice Address - Phone:971-715-0754
Practice Address - Fax:971-206-9686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-28
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Single Specialty