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General NPI Number Information
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NPI Number | 1427427376
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Entity Type | Organization
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Legal Business Name | JOURNEY'S COMMUNITY CENTER INC.
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Dates
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Enumeration Date | 09/22/2015
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 4939 W FULLERTON AVE
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City | CHICAGO
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State | IL
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Zip | 60639-2505
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Country | US
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Telephone | 708-683-9725
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Fax |
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Provider Business Mailing Address
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Address Line | 4939 W FULLERTON AVE
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City | CHICAGO
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State | IL
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Zip | 60639-2505
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Country | US
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Telephone | 304-844-2124
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | KATE M HARBERT
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Credential |
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Telephone | 708-683-9725
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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 | 180.009820
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License Number State | IL
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 180.009820
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License Number State | IL
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