Healthcare Provider Details

I. General information

NPI: 1902618945
Provider Name (Legal Business Name): JOURNEY TO HOPE COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 01/27/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 LAFAYETTE BLVD STE 100
FREDERICKSBURG VA
22401-6079
US

IV. Provider business mailing address

307 LAFAYETTE BLVD STE 100
FREDERICKSBURG VA
22401-6079
US

V. Phone/Fax

Practice location:
  • Phone: 540-479-1661
  • Fax: 540-479-1663
Mailing address:
  • Phone: 540-479-1661
  • Fax: 540-479-1663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SUSAN BLOCKER WALDEN
Title or Position: MANAGING PARTNER
Credential: MA, LPC, NCC
Phone: 540-479-1661