Healthcare Provider Details

I. General information

NPI: 1811814817
Provider Name (Legal Business Name): FEARLESS JOURNEY COUNSELING & CONSULTING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3473 HODGES RD
KINGMAN AZ
86409-0917
US

IV. Provider business mailing address

3473 HODGES RD
KINGMAN AZ
86409-0917
US

V. Phone/Fax

Practice location:
  • Phone: 507-829-0079
  • Fax:
Mailing address:
  • Phone: 507-829-0079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: ANDREA LUSTFIELD
Title or Position: OWNER
Credential: LPC
Phone: 507-829-0079