| Journey Therapeutic Services | |
|
1905 Huguenot Rd Ste 306 North Chesterfield VA 23235-4312 | |
| (804) 301-3424 | |
| Not Available |
| Full Name | Journey Therapeutic Services |
|---|---|
| Speciality | Counselor |
| Location | 1905 Huguenot Rd Ste 306, North Chesterfield, Virginia |
| Authorized Official Name and Position | Sumara Keyanna Wiggins (CLINICIAN/OWNER) |
| Authorized Official Contact | 8043013424 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Journey Therapeutic Services 2806 Botone Ave North Chesterfield VA 23237-2068 Ph: (804) 301-3424 | Journey Therapeutic Services 1905 Huguenot Rd Ste 306 North Chesterfield VA 23235-4312 Ph: (804) 301-3424 |
| NPI Number | 1821704719 |
|---|---|
| Provider Enumeration Date | 01/25/2023 |
| Last Update Date | 11/06/2023 |
| Certification Date | 11/06/2023 |
| Medicare PECOS PAC ID | 2163861022 |
|---|---|
| Medicare Enrollment ID | O20240411004742 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821704719 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Sumara Wiggins |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003481771 PECOS PAC ID: 3072952936 Enrollment ID: I20240411004773 |
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