Healthcare Provider Details

I. General information

NPI: 1265263149
Provider Name (Legal Business Name): YOUR JOURNEY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2024
Last Update Date: 01/17/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1122 LADY ST # 1312
COLUMBIA SC
29201-3218
US

IV. Provider business mailing address

1122 LADY ST # 1312
COLUMBIA SC
29201-3218
US

V. Phone/Fax

Practice location:
  • Phone: 803-871-0081
  • Fax: 802-214-5892
Mailing address:
  • Phone: 803-871-0081
  • Fax: 802-214-5892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. FELICIA L WALKER
Title or Position: CEO/PSYCHIATRIST
Credential: MD
Phone: 803-871-0081