Healthcare Provider Details

I. General information

NPI: 1265056980
Provider Name (Legal Business Name): GUIDED JOURNEYS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2020
Last Update Date: 05/29/2020
Certification Date: 05/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4601 PRESIDENTS DR STE 135
LANHAM MD
20706-4894
US

IV. Provider business mailing address

9601 WOODLAND AVE
LANHAM MD
20706-4023
US

V. Phone/Fax

Practice location:
  • Phone: 240-473-3404
  • Fax:
Mailing address:
  • Phone: 240-473-3404
  • 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: TALECIA FRAZIER
Title or Position: CEO/THERAPIST
Credential:
Phone: 240-473-3404