Provider Demographics
NPI:1679201719
Name:JOURNEY TO WELLNESS MENTAL HEALTH SERVICES, LLC
Entity type:Organization
Organization Name:JOURNEY TO WELLNESS MENTAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:DR
Authorized Official - First Name:CIARA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, CRNP
Authorized Official - Phone:240-255-9804
Mailing Address - Street 1:9711 WASHINGTONIAN BLVD STE 550
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-5789
Mailing Address - Country:US
Mailing Address - Phone:240-255-9804
Mailing Address - Fax:240-348-8923
Practice Address - Street 1:9711 WASHINGTONIAN BLVD STE 550
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-5789
Practice Address - Country:US
Practice Address - Phone:240-255-9804
Practice Address - Fax:240-348-8923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty