MEDICARE: JOURNEY HEALTH CENTER

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871109181
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOURNEY HEALTH CENTER

Provider Business Mailing Address
First Line	:	1511 WILD CRANBERRY DR
Second Line	:
City	:	CROWNSVILLE
State	:	MD
Zip	:	21032-2018
Country	:	US
Telephone Number	:	410-209-7041
Fax Number	:	410-510-1354

Provider Business Practice Location Address
First Line	:	1808 WOODLAWN DR STE O
Second Line	:
City	:	GWYNN OAK
State	:	MD
Zip	:	21207-4023
Country	:	US
Telephone Number	:	410-298-0734
Fax Number	:	410-510-1354

Authorized Official
Title or Position	:	OWNER
Name	:	ROBIN LYNN WARREN
Credential	:	DNP, CRNP, PMHNP
Telephone Number	:	410-209-7041

Provider Enumeration Date	:	09/22/2020
Last Update Date	:	09/06/2023

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Directions to “JOURNEY HEALTH CENTER ” Practice Location

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