Healthcare Provider Details

I. General information

NPI: 1336391341
Provider Name (Legal Business Name): JOURNEY COUNSELING MINISTRIES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2008
Last Update Date: 10/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 W COLLEGE ST
BRIDGEWATER VA
22812-1124
US

IV. Provider business mailing address

PO BOX 14
DAYTON VA
22821-0014
US

V. Phone/Fax

Practice location:
  • Phone: 540-908-2792
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701002278
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number0717000043
License Number StateVA

VIII. Authorized Official

Name: MR. JOHN KUEBLER
Title or Position: CHAIRMAN OF THE BOARD OF DIRECTORS
Credential:
Phone: 540-433-3051