Healthcare Provider Details

I. General information

NPI: 1427427376
Provider Name (Legal Business Name): JOURNEY'S COMMUNITY CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2015
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4939 W FULLERTON AVE
CHICAGO IL
60639-2505
US

IV. Provider business mailing address

4939 W FULLERTON AVE
CHICAGO IL
60639-2505
US

V. Phone/Fax

Practice location:
  • Phone: 708-683-9725
  • Fax:
Mailing address:
  • Phone: 304-844-2124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.009820
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180.009820
License Number StateIL

VIII. Authorized Official

Name: KATE M HARBERT
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 708-683-9725