Provider Demographics
NPI:1811254964
Name:JUST A JOURNEY COUNSELING & PSYCHOLOGICAL SERVICES, LLC
Entity type:Organization
Organization Name:JUST A JOURNEY COUNSELING & PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NIKHOL
Authorized Official - Middle Name:B
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, MFT
Authorized Official - Phone:770-377-4834
Mailing Address - Street 1:25 CLOUD FOREST COURT
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-5591
Mailing Address - Country:US
Mailing Address - Phone:770-377-4834
Mailing Address - Fax:404-393-7767
Practice Address - Street 1:157 BURKE STREET SUITE 119
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-3173
Practice Address - Country:US
Practice Address - Phone:678-249-9311
Practice Address - Fax:404-393-7767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-13
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC002388251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health