MEDICARE: DISTINGUISHED JOURNEYS

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	:	1164386686
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DISTINGUISHED JOURNEYS

Provider Business Mailing Address
First Line	:	320 LANIER AVE W STE 200
Second Line	:
City	:	FAYETTEVILLE
State	:	GA
Zip	:	30214-7443
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4166 SNAPFINGER WOODS DR
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30035-3411
Country	:	US
Telephone Number	:	404-947-8303
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PROGRAM DIRECTOR
Name	:	NICOLE R WALTON
Credential	:
Telephone Number	:	678-527-9699

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	12/10/2025

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Directions to “DISTINGUISHED JOURNEYS ” Practice Location

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