| Journey To Inner Wellness Llc | |
|
2242 Townside Dr Bishop GA 30621-6400 | |
| (706) 240-0371 | |
| Not Available |
| Full Name | Journey To Inner Wellness Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2242 Townside Dr, Bishop, Georgia |
| Authorized Official Name and Position | Tyshawn Kingsberry (CEO) |
| Authorized Official Contact | 7062400371 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Journey To Inner Wellness Llc 2242 Townside Dr Bishop GA 30621-6400 Ph: () - | Journey To Inner Wellness Llc 2242 Townside Dr Bishop GA 30621-6400 Ph: (706) 240-0371 |
| NPI Number | 1205695194 |
|---|---|
| Provider Enumeration Date | 03/14/2024 |
| Last Update Date | 05/21/2024 |
| Certification Date | 05/21/2024 |
| Medicare PECOS PAC ID | 1658713417 |
|---|---|
| Medicare Enrollment ID | O20240524000171 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205695194 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
| Provider Name | Tyshawn Kingsberry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932297652 PECOS PAC ID: 6305186933 Enrollment ID: I20190319001056 |
Kindred Therapy, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1467 Charlottes Walk, Bishop, GA 30621 Phone: 706-546-6733 |