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General NPI Number Information
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NPI Number | 1780156174
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Entity Type | Organization
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Legal Business Name | GRACEFUL JOURNEY COUNSELING SERVICES
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Dates
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Enumeration Date | 12/22/2018
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Last Update Date | 12/22/2018
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Provider Practice Location Address
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Address Line | 3901 ARLINGTON HIGHLANDS BLVD STE 293
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City | ARLINGTON
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State | TX
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Zip | 76018-6036
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Country | US
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Telephone | 404-519-6671
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Fax |
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Provider Business Mailing Address
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Address Line | 1621 QUAILS NEST DR
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City | FORT WORTH
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State | TX
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Zip | 76177-7543
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Country | US
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Telephone | 404-519-6671
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. TORI S DIXON
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Credential | LPC
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Telephone | 404-519-6671
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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