Provider Demographics
NPI:1124799275
Name:THE BLENDED JOURNEY
Entity type:Organization
Organization Name:THE BLENDED JOURNEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYD
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:267-243-0484
Mailing Address - Street 1:1921 PENFIELD ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19138-2716
Mailing Address - Country:US
Mailing Address - Phone:267-243-0484
Mailing Address - Fax:
Practice Address - Street 1:1921 PENFIELD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19138-2716
Practice Address - Country:US
Practice Address - Phone:267-243-0484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty