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General NPI Number Information
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NPI Number | 1003375338
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Entity Type | Organization
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Legal Business Name | THE JOURNEY THERAPY LLC
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Dates
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Enumeration Date | 03/16/2019
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Last Update Date | 03/16/2019
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Provider Practice Location Address
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Address Line | 328 ULUNIU ST STE 202
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City | KAILUA
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State | HI
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Zip | 96734-2542
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Country | US
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Telephone | 808-277-2273
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Fax | 866-278-4162
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Provider Business Mailing Address
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Address Line | 515 ONEAWA ST
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City | KAILUA
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State | HI
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Zip | 96734-2228
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Country | US
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Telephone | 808-277-2273
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Fax | 866-278-4162
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Authorized Official
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Title or Position | OWNER
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Name | MS. BETHANY CROWLEY
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Credential | MFT, CEDS
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Telephone | 808-277-2273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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