MEDICARE: JOURNEY THERAPY GROUP

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	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1730950445
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOURNEY THERAPY GROUP

Provider Business Mailing Address
First Line	:	17221 BRAXTON ST
Second Line	:
City	:	GRANADA HILLS
State	:	CA
Zip	:	91344-1516
Country	:	US
Telephone Number	:	818-442-5014
Fax Number	:

Provider Business Practice Location Address
First Line	:	1023 N HOLLYWOOD WAY STE 105A
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-2554
Country	:	US
Telephone Number	:	818-465-8863
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LUCY GULATYAN
Credential	:	LMFT
Telephone Number	:	818-465-8863

Provider Enumeration Date	:	01/11/2024
Last Update Date	:	10/28/2024

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Directions to “JOURNEY THERAPY GROUP ” Practice Location

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