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General NPI Number Information
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NPI Number | 1679272116
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Entity Type | Organization
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Legal Business Name | PROTOSTAR JOURNEY PLLC
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Dates
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Enumeration Date | 02/23/2023
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 515 S 1ST ST STE L
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City | LUFKIN
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State | TX
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Zip | 75901-3867
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Country | US
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Telephone | 409-489-2135
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Fax |
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Provider Business Mailing Address
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Address Line | 1214 ELLIS AVE
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City | LUFKIN
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State | TX
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Zip | 75904-3326
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Country | US
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Telephone | 936-937-0074
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Fax | 936-637-0081
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Authorized Official
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Title or Position | COUNSELOR/OWNER
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Name | MARGUERITE BRADEN
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Credential | LPC
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Telephone | 936-937-0074
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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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