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General NPI Number Information
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NPI Number | 1497122527
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Entity Type | Organization
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Legal Business Name | A NEW JOURNEY COUNSELING
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Dates
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Enumeration Date | 08/24/2015
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Last Update Date | 04/27/2017
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Provider Practice Location Address
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Address Line | 234 N MAIN ST 3-E #200
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City | GUNNISON
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State | CO
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Zip | 81230-2438
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Country | US
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Telephone | 970-209-5933
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Fax |
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Provider Business Mailing Address
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Address Line | 423 COUNTY ROAD 13
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City | GUNNISON
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State | CO
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Zip | 81230-8722
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Country | US
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Telephone | 970-209-5933
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST/COUNSELOR
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Name | MRS. CAROL JOLENE GOLDFAINDAVIS
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Credential | LPC
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Telephone | 970-209-5933
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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 | 0003118
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License Number State | CO
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