Healthcare Provider Details

I. General information

NPI: 1396649497
Provider Name (Legal Business Name): MY JOURNEY FORENSIC SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 CENTER AVE
SCHUYLKILL HAVEN PA
17972-1003
US

IV. Provider business mailing address

107 CENTER AVE RB
SCHUYLKILL HAVEN PA
17972-1003
US

V. Phone/Fax

Practice location:
  • Phone: 267-490-7055
  • Fax:
Mailing address:
  • Phone: 267-490-7055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. JASON YANTIN
Title or Position: PRESIDENT
Credential:
Phone: 267-490-7055