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NPI Code Detail

MEDICARE: JOURNEY 2 WELLNESS LLC

MEDICARE: JOURNEY 2 WELLNESS LLC
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
1261QM0850XAdult Mental Health Clinic/Center

General Provider Information

NPI Number : 1831883859
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOURNEY 2 WELLNESS LLC
Provider Business Mailing Address
First Line : 3557 JUANIPERO WAY
Second Line :
City : MEDFORD
State : OR
Zip : 97504-4319
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1605 SISKIYOU BLVD
Second Line :
City : ASHLAND
State : OR
Zip : 97520-2400
Country : US
Telephone Number : 541-920-0817
Fax Number :
Authorized Official
Title or Position : THERAPIST
Name : CHRISTY IVORY
Credential : LPC
Telephone Number : 541-920-0817
Provider Enumeration Date : 06/05/2023
Last Update Date : 08/28/2024

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Directions to “JOURNEY 2 WELLNESS LLC ” Practice Location

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