Healthcare Provider Details

I. General information

NPI: 1457820508
Provider Name (Legal Business Name): JOURNEY COUNSELING SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2018
Last Update Date: 12/15/2020
Certification Date: 12/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1193 HOOKSETT RD STE 2
HOOKSETT NH
03106-1091
US

IV. Provider business mailing address

1193 HOOKSETT RD STE 2
HOOKSETT NH
03106-1091
US

V. Phone/Fax

Practice location:
  • Phone: 603-777-0361
  • Fax: 603-413-4633
Mailing address:
  • Phone: 603-777-0361
  • Fax: 603-413-4633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1003066465
Identifier TypeOTHER
Identifier StateNH
Identifier IssuerNPI

VIII. Authorized Official

Name: JULIA GAMACHE
Title or Position: OWNER
Credential: LICSW, MLADC
Phone: 603-777-0361