MEDICARE: INNER JOURNEY HEALTHCARE PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	103TP2701X	Group Psychotherapy Psychologist
2	207Q00000X	Family Medicine Physician
3	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1205654209
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNER JOURNEY HEALTHCARE PLLC

Provider Business Mailing Address
First Line	:	121 HICKORY ST STE 4
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59801-1896
Country	:	US
Telephone Number	:	406-541-2012
Fax Number	:

Provider Business Practice Location Address
First Line	:	121 HICKORY ST STE 1
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59801-1896
Country	:	US
Telephone Number	:	406-296-5071
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTORY
Name	:	DR. JOEY BANKS
Credential	:	MD
Telephone Number	:	406-296-5071

Provider Enumeration Date	:	09/30/2024
Last Update Date	:	03/06/2025

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