Healthcare Provider Details

I. General information

NPI: 1316950801
Provider Name (Legal Business Name): JOURNEYS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2929 COORS BLVD NW STE 102B
ALBUQUERQUE NM
87120-1224
US

IV. Provider business mailing address

2929 COORS BLVD NW STE 102B
ALBUQUERQUE NM
87120-1224
US

V. Phone/Fax

Practice location:
  • Phone: 505-314-7012
  • Fax: 505-839-7990
Mailing address:
  • Phone: 505-314-7012
  • Fax: 505-839-7990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0068832
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number005796
License Number StateNM

VIII. Authorized Official

Name: DONNA MARIE LUCERO
Title or Position: THERAPIST/OWNER
Credential: LPCC
Phone: 505-314-7012