MEDICARE: FAMILY JOURNEYS, 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
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1972148617
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY JOURNEYS, LLC

Provider Business Mailing Address
First Line	:	880 S LAKESHORE DR
Second Line	:
City	:	VALDOSTA
State	:	GA
Zip	:	31605-6429
Country	:	US
Telephone Number	:	229-242-1700
Fax Number	:

Provider Business Practice Location Address
First Line	:	1803 CANTERBURY DR STE C
Second Line	:
City	:	VALDOSTA
State	:	GA
Zip	:	31602-0505
Country	:	US
Telephone Number	:	229-588-4051
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER, THERAPIST
Name	:	MRS. LAURIE ANNE WALLACE
Credential	:	LMFT
Telephone Number	:	229-242-1700

Provider Enumeration Date	:	11/15/2019
Last Update Date	:	03/04/2024

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Directions to “FAMILY JOURNEYS, LLC ” Practice Location

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