Healthcare Provider Details

I. General information

NPI: 1427786508
Provider Name (Legal Business Name): JOURNEY BOUND COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2022
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 N BARR RD
PORT ANGELES WA
98362-8113
US

IV. Provider business mailing address

703 N BARR RD
PORT ANGELES WA
98362-8113
US

V. Phone/Fax

Practice location:
  • Phone: 360-643-3625
  • Fax:
Mailing address:
  • Phone: 360-643-3625
  • 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: DEANNA VERMULM
Title or Position: PRESIDENT
Credential: LICSW
Phone: 858-386-2149