MEDICARE: JOURNEY SUPPORT SERVICES INC

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	101YM0800X	Mental Health Counselor
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1134690589
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOURNEY SUPPORT SERVICES INC

Provider Business Mailing Address
First Line	:	3266 N MERIDIAN ST STE 801
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46208-5834
Country	:	US
Telephone Number	:	317-986-7106
Fax Number	:

Provider Business Practice Location Address
First Line	:	3266 N MERIDIAN ST STE 801
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46208-5834
Country	:	US
Telephone Number	:	317-986-7106
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DOSHIA FIFER
Credential	:	MSW, LCSW
Telephone Number	:	317-619-5641

Provider Enumeration Date	:	12/11/2018
Last Update Date	:	08/04/2023

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Directions to “JOURNEY SUPPORT SERVICES INC ” Practice Location

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