Healthcare Provider Details

I. General information

NPI: 1609746403
Provider Name (Legal Business Name): A JOURNEY FOR HEALING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

457 WASHINGTON ST SE
ALBUQUERQUE NM
87108-2713
US

IV. Provider business mailing address

457 WASHINGTON ST SE STE E
ALBUQUERQUE NM
87108-2713
US

V. Phone/Fax

Practice location:
  • Phone: 317-727-7690
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE KITTS
Title or Position: LPCC/OWNER
Credential: MA, LPCC
Phone: 317-727-7690