Healthcare Provider Details

I. General information

NPI: 1700447281
Provider Name (Legal Business Name): HEALING JOURNEY COUNSELING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2019
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 STUBBS AVE STE D
MONROE LA
71201-5566
US

IV. Provider business mailing address

801 STUBBS AVE STE D
MONROE LA
71201-5566
US

V. Phone/Fax

Practice location:
  • Phone: 318-537-1925
  • Fax:
Mailing address:
  • Phone:
  • 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: MYISHA MYERS JACKSON
Title or Position: OWNER
Credential: LPC
Phone: 318-582-5147