Healthcare Provider Details

I. General information

NPI: 1003375338
Provider Name (Legal Business Name): THE JOURNEY THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2019
Last Update Date: 03/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 ULUNIU ST STE 202
KAILUA HI
96734-2542
US

IV. Provider business mailing address

515 ONEAWA ST
KAILUA HI
96734-2228
US

V. Phone/Fax

Practice location:
  • Phone: 808-277-2273
  • Fax: 866-278-4162
Mailing address:
  • Phone: 808-277-2273
  • Fax: 866-278-4162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. BETHANY CROWLEY
Title or Position: OWNER
Credential: MFT, CEDS
Phone: 808-277-2273