Provider Demographics
NPI:1770123861
Name:JOURNEY'S EVE COUNSELING PLLC
Entity type:Organization
Organization Name:JOURNEY'S EVE COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:WEBER
Authorized Official - Last Name:WADE
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:201-953-0276
Mailing Address - Street 1:2403 KIMRA LN
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-1608
Mailing Address - Country:US
Mailing Address - Phone:201-953-0276
Mailing Address - Fax:
Practice Address - Street 1:1001 CYPRESS CREEK RD STE 301
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-4469
Practice Address - Country:US
Practice Address - Phone:201-953-0276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-07
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)