MEDICARE: THE JOURNEY FORWARD - THERAPY SERVICES, PLLC

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1225887672
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE JOURNEY FORWARD - THERAPY SERVICES, PLLC

Provider Business Mailing Address
First Line	:	100 1/2 14TH ST
Second Line	:
City	:	WHEELING
State	:	WV
Zip	:	26003-3407
Country	:	US
Telephone Number	:	304-830-7546
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 1/2 14TH ST
Second Line	:
City	:	WHEELING
State	:	WV
Zip	:	26003-3407
Country	:	US
Telephone Number	:	304-830-7546
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	AMY MOSES
Credential	:	MSW, LICSW
Telephone Number	:	304-780-1391

Provider Enumeration Date	:	05/17/2024
Last Update Date	:	05/17/2024

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