Provider Demographics
NPI:1750954251
Name:HEALING JOURNEYS, LLC
Entity type:Organization
Organization Name:HEALING JOURNEYS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER, CARE PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:FITZGERALD
Authorized Official - Suffix:
Authorized Official - Credentials:RN, QMHP-E
Authorized Official - Phone:540-305-3315
Mailing Address - Street 1:25 TINKLING SPRING RD
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-2261
Mailing Address - Country:US
Mailing Address - Phone:540-305-3315
Mailing Address - Fax:977-920-1925
Practice Address - Street 1:25 TINKLING SPRING RD
Practice Address - Street 2:
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939-2261
Practice Address - Country:US
Practice Address - Phone:540-305-3315
Practice Address - Fax:977-920-1925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1013541713Medicaid