Healthcare Provider Details

I. General information

NPI: 1134631054
Provider Name (Legal Business Name): JOURNEYS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2017
Last Update Date: 11/30/2023
Certification Date: 11/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5201 W WOODMILL DR
WILMINGTON DE
19808-4068
US

IV. Provider business mailing address

5201 W WOODMILL DR STE 31
WILMINGTON DE
19808-4068
US

V. Phone/Fax

Practice location:
  • Phone: 302-384-7843
  • Fax:
Mailing address:
  • Phone: 302-384-7843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. REBECCA DAWN TRENT
Title or Position: OWNER
Credential: DSOCSCI, LPCMH, CADC
Phone: 443-945-0615