MEDICARE: JOURNEY TOGETHER COUNSELING

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	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1124990692
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOURNEY TOGETHER COUNSELING

Provider Business Mailing Address
First Line	:	808 WASHINGTON AVE STE 22D
Second Line	:
City	:	DETROIT LAKES
State	:	MN
Zip	:	56501-3068
Country	:	US
Telephone Number	:	218-849-7524
Fax Number	:	218-203-0441

Provider Business Practice Location Address
First Line	:	808 WASHINGTON AVE STE 22D
Second Line	:
City	:	DETROIT LAKES
State	:	MN
Zip	:	56501-3068
Country	:	US
Telephone Number	:	218-849-7524
Fax Number	:	218-203-0441

Authorized Official
Title or Position	:	OWNER/COUNSELOR
Name	:	MELISSA JEAN LONGTINE
Credential	:	LPCC
Telephone Number	:	218-849-7524

Provider Enumeration Date	:	09/23/2025
Last Update Date	:	09/23/2025

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