| Journey Within Christian Counseling, Llc | |
|
11414 W Park Pl Milwaukee WI 53224-3500 | |
| (262) 297-6680 | |
| (262) 364-2742 |
| Full Name | Journey Within Christian Counseling, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 11414 W Park Pl, Milwaukee, Wisconsin |
| Authorized Official Name and Position | Domaz Wellington (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 2622976680 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Journey Within Christian Counseling, Llc 11414 W Park Pl Milwaukee WI 53224-3500 Ph: (262) 297-6680 | Journey Within Christian Counseling, Llc 11414 W Park Pl Milwaukee WI 53224-3500 Ph: (262) 297-6680 |
| NPI Number | 1639946098 |
|---|---|
| Provider Enumeration Date | 12/06/2023 |
| Last Update Date | 12/06/2023 |
| Certification Date | 12/06/2023 |
| Medicare PECOS PAC ID | 3678911195 |
|---|---|
| Medicare Enrollment ID | O20240403001907 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639946098 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Domaz Wellington |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427466721 PECOS PAC ID: 9032562723 Enrollment ID: I20240403002116 |
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