Provider Demographics
NPI:1699894568
Name:NEW JOURNEY COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:NEW JOURNEY COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VEEDA
Authorized Official - Middle Name:JENE
Authorized Official - Last Name:SMALLS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:803-775-5261
Mailing Address - Street 1:PO BOX 1627
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29151-1627
Mailing Address - Country:US
Mailing Address - Phone:803-775-5261
Mailing Address - Fax:803-773-8111
Practice Address - Street 1:533 OXFORD ST
Practice Address - Street 2:SUITE D
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-3353
Practice Address - Country:US
Practice Address - Phone:803-775-5261
Practice Address - Fax:803-773-8111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2585101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
499995OtherVALUE OPTIONS
11318685OtherCAQH