Healthcare Provider Details

I. General information

NPI: 1669366886
Provider Name (Legal Business Name): SOJOURN BEHAVIORAL HEALTH AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2025
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 SPRING HILL DR
KOKOMO IN
46902-5655
US

IV. Provider business mailing address

900 SPRING HILL DR
KOKOMO IN
46902-5655
US

V. Phone/Fax

Practice location:
  • Phone: 765-398-8377
  • Fax:
Mailing address:
  • Phone: 765-398-8377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State

VIII. Authorized Official

Name: ALEXIUS Q BABB
Title or Position: OWNER/CLINICAL PSYCHOLOGIST
Credential: PSYD
Phone: 765-398-8377