Healthcare Provider Details

I. General information

NPI: 1548957863
Provider Name (Legal Business Name): YOUR JOURNEY TO HEALING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2023
Last Update Date: 10/05/2026
Certification Date: 04/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1408 CHASE WAY
CROWLEY TX
76036
US

IV. Provider business mailing address

1660 S UNIVERSITY DR # 1102
FORT WORTH TX
76107-6524
US

V. Phone/Fax

Practice location:
  • Phone: 469-454-0894
  • Fax:
Mailing address:
  • Phone: 469-454-0894
  • Fax: 682-316-9979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL

VIII. Authorized Official

Name: VARISSA OWENS
Title or Position: THERAPIST
Credential: M.S., MA, LPC-S, NCC
Phone: 469-454-0894