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General NPI Number Information
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NPI Number | 1790429652
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Entity Type | Organization
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Legal Business Name | JOURNEY COUNSELING CORP
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Dates
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Enumeration Date | 04/26/2022
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Last Update Date | 05/04/2022
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Provider Practice Location Address
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Address Line | 1103 JENSON AVE SE
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City | WATERTOWN
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State | SD
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Zip | 57201-5259
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Country | US
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Telephone | 605-878-1234
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Fax | 605-878-2211
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Provider Business Mailing Address
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Address Line | 1103 JENSON AVE SE
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City | WATERTOWN
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State | SD
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Zip | 57201-5259
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Country | US
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Telephone | 605-878-1234
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Fax | 605-878-2211
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Authorized Official
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Title or Position | CLINICAL THERAPIST
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Name | MARY KAY JOHNSON
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Credential | CSW-PIP
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Telephone | 605-881-0860
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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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 |
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License Number State |
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