Healthcare Provider Details

I. General information

NPI: 1588570246
Provider Name (Legal Business Name): ON THE JOURNEY COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3506 S CULPEPPER CIR STE D
SPRINGFIELD MO
65804-4251
US

IV. Provider business mailing address

3506 S CULPEPPER CIR STE D
SPRINGFIELD MO
65804-4251
US

V. Phone/Fax

Practice location:
  • Phone: 870-321-2979
  • Fax:
Mailing address:
  • Phone: 870-321-2979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: KATELIN RENOUF
Title or Position: LPC
Credential: MS
Phone: 870-321-2979