| Organization Name: | JOURNEYS COUNSELING CENTER, LLC |
| NPI Number: | 1003259334 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT DAVID RUSSELL (COUNSELOR) |
| Mailing Address: | 200 S Carroll Rd Villa Rica |
| State: | GA US |
| Postal Code: | 301802606 |
| Phone Number: | 4044523789 |
| Fax Number: | |
| NPI Enumeration Date: | 04/17/2013 |
| NPI Last Update Date: | 04/17/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LPC004424,LPC004531 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |