Provider Demographics
NPI:1639902497
Name:JOURNEY TO CHANGE THERAPY, PLLC
Entity type:Organization
Organization Name:JOURNEY TO CHANGE THERAPY, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO, LCSW
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:CHASTAIN
Authorized Official - Last Name:TEWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MDIV, MSW, LCSW
Authorized Official - Phone:828-361-7901
Mailing Address - Street 1:23 CALEDONIA DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-1797
Mailing Address - Country:US
Mailing Address - Phone:828-361-7901
Mailing Address - Fax:
Practice Address - Street 1:2255 OLD MURPHY RD STE 104
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-7205
Practice Address - Country:US
Practice Address - Phone:828-361-7900
Practice Address - Fax:534-220-3538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-26
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0904017159OtherVIRGINIA BOARD OF SOCIAL WORKERS
NCC009647OtherNC BOARD OF SOCIAL WORK LICENSURE AND CERTIFICATION
GACSW009497OtherGA BOARD OF COUNSELORS, SOCIAL WORKERS, AND MARRIAGE AND FAMILY THERAPISTS