MEDICARE: JOURNEY FORWARD COUNSELING SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1083427314
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOURNEY FORWARD COUNSELING SERVICES LLC

Provider Business Mailing Address
First Line	:	8137 FEDORA DR
Second Line	:
City	:	CHESTERFIELD
State	:	VA
Zip	:	23838-6288
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	24B W OLD ST
Second Line	:
City	:	PETERSBURG
State	:	VA
Zip	:	23803-3222
Country	:	US
Telephone Number	:	804-546-1207
Fax Number	:

Authorized Official
Title or Position	:	CEO/DIRECTOR
Name	:	JALEN DANIELY
Credential	:
Telephone Number	:	804-546-1207

Provider Enumeration Date	:	01/30/2025
Last Update Date	:	02/01/2025

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