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NPI Code Detail

MEDICARE: AUTHENTIC JOURNEY THERAPY CENTER LLC

MEDICARE: AUTHENTIC JOURNEY THERAPY CENTER 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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1871452300
Entity Type Code : Organization
Provider Name (Legal Business Name) : AUTHENTIC JOURNEY THERAPY CENTER LLC
Provider Business Mailing Address
First Line : 3301 SANDBURG TER
Second Line :
City : OLNEY
State : MD
Zip : 20832-2531
Country : US
Telephone Number : 240-200-0937
Fax Number :
Provider Business Practice Location Address
First Line : 3301 SANDBURG TER
Second Line :
City : OLNEY
State : MD
Zip : 20832-2531
Country : US
Telephone Number : 240-200-0937
Fax Number :
Authorized Official
Title or Position : OWNER/PSYCHOTHERAPIST
Name : ALICIA COHEN
Credential :
Telephone Number : 240-242-5160
Provider Enumeration Date : 01/20/2026
Last Update Date : 01/20/2026

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Directions to “AUTHENTIC JOURNEY THERAPY CENTER LLC ” Practice Location

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