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General NPI Number Information
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NPI Number | 1194456616
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Entity Type | Organization
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Legal Business Name | JOURNEY TO PRESENT INC.
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Dates
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Enumeration Date | 06/23/2022
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Last Update Date | 06/23/2022
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Provider Practice Location Address
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Address Line | 28 S 5TH ST
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City | GENEVA
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State | IL
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Zip | 60134-2111
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Country | US
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Telephone | 847-287-0916
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Fax |
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Provider Business Mailing Address
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Address Line | 863 RAVINIA CT
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City | BATAVIA
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State | IL
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Zip | 60510-3213
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Country | US
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Telephone | 847-287-0916
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MELISSA MAHON
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Credential | PSY.D.
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Telephone | 847-287-0916
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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