Journey Therapy, Llc | |
40 Pheasant Ct Elizabethtown PA 17022-9206 | |
(717) 964-8897 | |
Not Available |
Full Name | Journey Therapy, Llc |
---|---|
Speciality | Psychologist |
Location | 40 Pheasant Ct, Elizabethtown, Pennsylvania |
Authorized Official Name and Position | Tegan Blackbird (OWNER) |
Authorized Official Contact | 7179648897 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Journey Therapy, Llc 40 Pheasant Ct Elizabethtown PA 17022-9206 Ph: () - | Journey Therapy, Llc 40 Pheasant Ct Elizabethtown PA 17022-9206 Ph: (717) 964-8897 |
NPI Number | 1477164895 |
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Provider Enumeration Date | 08/10/2020 |
Last Update Date | 07/02/2021 |
Certification Date | 07/02/2021 |
Medicare PECOS PAC ID | 6002233897 |
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Medicare Enrollment ID | O20200825001536 |
Identifier | Type | State | Issuer |
---|---|---|---|
1477164895 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
Provider Name | Tegan Blackbird |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1841211026 PECOS PAC ID: 0042226029 Enrollment ID: I20060301000319 |
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