MEDICARE: CLEAR JOURNEY COUNSELING & PROFESSIONAL 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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1588545016
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEAR JOURNEY COUNSELING & PROFESSIONAL SERVICES, LLC

Provider Business Mailing Address
First Line	:	1422 GRANVILLE PL
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63112-4202
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1422 GRANVILLE PL
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63112-4202
Country	:	US
Telephone Number	:	314-680-7306
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MR. MOYENDA ANWISYE
Credential	:	LPC
Telephone Number	:	314-749-5954

Provider Enumeration Date	:	09/10/2025
Last Update Date	:	09/10/2025

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