Provider Demographics
NPI:1316300908
Name:JOURNEY THROUGH LIFE TX LLC
Entity type:Organization
Organization Name:JOURNEY THROUGH LIFE TX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:N
Authorized Official - Last Name:LAURENT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:919-758-3082
Mailing Address - Street 1:5974 MYAKKA CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-3265
Mailing Address - Country:US
Mailing Address - Phone:919-758-3082
Mailing Address - Fax:225-590-3324
Practice Address - Street 1:7151 OFFICE CITY DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77087
Practice Address - Country:US
Practice Address - Phone:919-758-3082
Practice Address - Fax:919-809-8642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-31
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
TX251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase Management
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty