Provider Demographics
NPI:1699476770
Name:THERAPEUTIC JOURNEYS
Entity type:Organization
Organization Name:THERAPEUTIC JOURNEYS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSE PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:DARRECIA
Authorized Official - Middle Name:PRINCESS
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:313-971-6693
Mailing Address - Street 1:25835 MARY ST
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48051-2824
Mailing Address - Country:US
Mailing Address - Phone:313-971-6693
Mailing Address - Fax:
Practice Address - Street 1:25835 MARY ST
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48051-2824
Practice Address - Country:US
Practice Address - Phone:313-971-6693
Practice Address - Fax:586-690-8346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-15
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty