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General NPI Number Information
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NPI Number | 1083427314
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Entity Type | Organization
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Legal Business Name | JOURNEY FORWARD COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 01/30/2025
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Last Update Date | 02/01/2025
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Provider Practice Location Address
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Address Line | 24B W OLD ST
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City | PETERSBURG
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State | VA
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Zip | 23803-3222
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Country | US
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Telephone | 804-546-1207
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Fax |
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Provider Business Mailing Address
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Address Line | 8137 FEDORA DR
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City | CHESTERFIELD
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State | VA
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Zip | 23838-6288
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO/DIRECTOR
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Name | JALEN DANIELY
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Credential |
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Telephone | 804-546-1207
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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