MEDICARE: NEW JOURNEY PSYCHIATRY, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1093453649
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW JOURNEY PSYCHIATRY, PLLC

Provider Business Mailing Address
First Line	:	78 WHITING ST
Second Line	:
City	:	LUNENBURG
State	:	MA
Zip	:	01462-1451
Country	:	US
Telephone Number	:	978-407-4057
Fax Number	:

Provider Business Practice Location Address
First Line	:	370 MAIN ST STE 203C
Second Line	:
City	:	TOWNSEND
State	:	MA
Zip	:	01474-1052
Country	:	US
Telephone Number	:	508-887-1843
Fax Number	:

Authorized Official
Title or Position	:	CNP
Name	:	WENDY BARRY
Credential	:	MSN
Telephone Number	:	978-407-4057

Provider Enumeration Date	:	05/24/2022
Last Update Date	:	09/01/2023

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