Provider Demographics
NPI:1326891771
Name:JOURNEY COUNSELING AND WELLNESS,
Entity type:Organization
Organization Name:JOURNEY COUNSELING AND WELLNESS,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DRIRECTIOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SADE
Authorized Official - Middle Name:SMITH
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC, NCC, BCTMC
Authorized Official - Phone:571-417-7706
Mailing Address - Street 1:4000 LEGATO RD STE 1100
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-2893
Mailing Address - Country:US
Mailing Address - Phone:571-417-7706
Mailing Address - Fax:
Practice Address - Street 1:4000 LEGATO RD
Practice Address - Street 2:SUITE #1100
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033
Practice Address - Country:US
Practice Address - Phone:571-417-7706
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-08
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health