| Courageous Journey Psychological Services, Llc | |
|
168 Bluefish Ave Russellville AR 72802-2407 | |
| (479) 765-1187 | |
| Not Available |
| Full Name | Courageous Journey Psychological Services, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 168 Bluefish Ave, Russellville, Arkansas |
| Authorized Official Name and Position | Maggie James (OWNER) |
| Authorized Official Contact | 4797651187 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Courageous Journey Psychological Services, Llc 168 Bluefish Ave Russellville AR 72802-2407 Ph: () - | Courageous Journey Psychological Services, Llc 168 Bluefish Ave Russellville AR 72802-2407 Ph: (479) 765-1187 |
| NPI Number | 1821610171 |
|---|---|
| Provider Enumeration Date | 05/09/2020 |
| Last Update Date | 05/09/2020 |
| Certification Date | 05/09/2020 |
| Medicare PECOS PAC ID | 3072932714 |
|---|---|
| Medicare Enrollment ID | O20200930001588 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821610171 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Maggie James |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427503028 PECOS PAC ID: 6608155460 Enrollment ID: I20161118000011 |
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