Healthcare Provider Details

I. General information

NPI: 1295450245
Provider Name (Legal Business Name): JOURNEY TO WHOLENESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2022
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6065 NW 167TH ST STE B19
HIALEAH FL
33015-4394
US

IV. Provider business mailing address

16620 NW 77TH PL
MIAMI LAKES FL
33016-3432
US

V. Phone/Fax

Practice location:
  • Phone: 305-781-9753
  • Fax:
Mailing address:
  • Phone: 305-781-9753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH FLORES
Title or Position: OWNER/MANAGER
Credential: LMHC
Phone: 305-781-9753