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General NPI Number Information
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NPI Number | 1194297788
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Entity Type | Organization
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Legal Business Name | INNER JOURNEY COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 12/20/2018
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Last Update Date | 05/20/2023
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Provider Practice Location Address
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Address Line | 6412 US HIGHWAY 27 S
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City | SEBRING
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State | FL
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Zip | 33876-5711
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Country | US
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Telephone | 863-991-3232
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Fax |
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Provider Business Mailing Address
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Address Line | 6412 US HIGHWAY 27 S
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City | SEBRING
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State | FL
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Zip | 33876-5711
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Country | US
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Telephone | 863-991-3232
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Fax | 866-634-3605
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | MS. EVELYN DEJESUS
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Credential | LCSW
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Telephone | 863-991-3232
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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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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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