JOURNEY COUNSELING CENTER PROVO LLC (NPI# 1811319502) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811319502 |
| Entity Type | Organization |
| Organization Name | JOURNEY COUNSELING CENTER PROVO LLC |
| Practice Address |
619 N 500 W Provo UT 84601-1547 |
| Practice Telephone | 8013754240 |
| Practice Fax Number | 8013754241 |
| Mailing Telephone | 8013754240 |
| Mailing Fax Number | 8013754241 |
| Enumeration Date | 2014-01-14 |
| Last Update Date | 2014-01-14 |
| Authorized Official Name | VICKI GOODMAN (QUALITY ASSURANCE DIRECTOR) |
| Authorized Official Telephone | 8017850465 |
| Is Organization Subpart | Y |
| Parent Organization Name | THE JOURNEY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 253J00000X | Foster Care Agency | 20850 | UT | Agencies |
| Street Address |
619 N 500 W |
| City | PROVO |
| State | UT |
| Zip Code | 84601-1547 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417977505 | Susan R Dyle | Physician Assistant | 619 N 500 W, Provo, UT 84601-1547 | 2006-07-20 |
| 1902430531 | Brighter Path Addiction Medicine | Obstetrics & Gynecology | 619 N 500 W, Provo, UT 84601-1547 | 2020-02-21 |
| 1598267122 | Utah Addiction Medicine | Family Medicine | 619 N 500 W, Provo, UT 84601-1547 | 2018-02-28 |
| 1306387105 | Brenton Lisonbee | Counselor | 619 N 500 W, Provo, UT 84601-1547 | 2017-03-13 |
| 1114469921 | Janessa Rasmussen | Community Health Worker | 619 N 500 W, Provo, UT 84601-1547 | 2016-11-09 |
| 1750823563 | Camille Brown | Community Health Worker | 619 N 500 W, Provo, UT 84601-1547 | 2016-11-09 |
| 1922540731 | Keiyana Osmond | Community Health Worker | 619 N 500 W, Provo, UT 84601-1547 | 2016-11-09 |
| 1003358813 | Haley Allmendinger | Community Health Worker | 619 N 500 W, Provo, UT 84601-1547 | 2016-11-09 |
| 1740648898 | Alexis Zimmerman | Counselor | 619 N 500 W, Provo, UT 84601-1547 | 2016-02-04 |
| 1245697978 | Carlos Ensaldo | Counselor | 619 N 500 W, Provo, UT 84601-1547 | 2016-01-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902378417 | 1 Assist Care of Utah Valley LLC | In Home Supportive Care | 180 N University Avenue, Suite 270, Office 213, Provo, UT 84601 | 2018-12-21 |
| 1346723319 | Mp Dental LLC | Dentist | 777 N. 500 W. #204, Proud, UT 84601 | 2018-09-14 |
| 1326530601 | Madison Paige Nelson | Case Manager/Care Coordinator | 750 N Freedom Blvd., Provo, UT 84601 | 2018-06-03 |
| 1245758861 | Annette Roylance | Case Manager/Care Coordinator | 750 North Freedom Boulevard, Suite 300, Provo, UT 84601 | 2017-09-04 |
| 1912422205 | Alexandra Mcbride | Specialist/Technologist | 35 N 300 W #440, Provo, UT 84601 | 2017-08-07 |
| 1932638293 | Audrey Clara Clifton | Case Manager/Care Coordinator | 750 North Freedom Blvd., Provo, UT 84601 | 2017-06-08 |
| 1528514197 | Joseph Hyrum Lewis | Case Manager/Care Coordinator | 750 Freedom Blvd, Provo, UT 84601 | 2016-09-01 |
| 1629427620 | Walker Clements | Case Manager/Care Coordinator | 750 North Freedom Blvd, Provo, UT 84601 | 2016-06-09 |
| 1447611595 | Robert Shirley | Student in an Organized Health Care Education/Training Program | 750 North 200 West, Provo, Ut 84601., Provo, UT 84601 | 2016-03-17 |
| 1700286283 | Brelynn Downs | Student in an Organized Health Care Education/Training Program | 750 North Freedom Blvde, Provo, UT 84601 | 2014-09-03 |
| Find all providers in zip 84601 | ||||
| Taxonomy Code | 253J00000X |
| Grouping | Agencies |
| Classification | Foster Care Agency |
| A Foster Care Agency is an agency that provides foster care as defined in the Code of Federal Regulations (CFR) as "24-hour substitute care for children outside their own homes." Foster care settings include, but are not limited to, nonrelative foster family homes, relative foster homes (whether payments are being made or not), group homes, emergency shelters, residential facilities, and pre-adoptive homes. |
| Notes: Source: Code Of Federal Regulations, Title 45, Volume 4, Part 1355, Section 57 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619399144 | Journey Counseling Center Salt Lake LLC | Foster Care Agency | 920 Columbia Ln, Provo, UT 84604-1320 | 2014-01-17 |
| 1922421080 | True North Academy, LLC | Foster Care Agency | 900 Columbia Ln, Provo, UT 84604-1320 | 2014-01-27 |
| 1467875526 | Journey Homestead, LLC | Foster Care Agency | 920 Columbia Ln, Provo, UT 84604-1320 | 2014-01-27 |
| 1245558378 | The Journey | Foster Care Agency | 619 N 500 W, Provo, UT 84601-1547 | 2010-05-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154852507 | Wade Thomson | Foster Care Agency | 1363 S State St Ste 140, Salt Lake City, UT 84115-5540 | 2017-03-27 |
| 1922492057 | Live for Life Cypress | Foster Care Agency | 3023 N Bronzewood Cir, Erda, UT 84074-3302 | 2015-03-26 |
| 1609274158 | Kt&t Venures | Foster Care Agency | 1140 36th St Ste 160, Ogden, UT 84403-2054 | 2014-12-16 |
| 1396157350 | Brittany Lee Coleman | Foster Care Agency | 3900 S 200 E, Suite 16, Salt Lake City, UT 84107 | 2014-05-27 |
| 1225449630 | Youthtrack, Inc | Foster Care Agency | 862 S Main Suite 4, Brigham City, UT 84302 | 2014-05-20 |
| 1093130130 | Brenda Tekell | Foster Care Agency | 862 S Main St Ste 201, Brigham City, UT 84302-3320 | 2014-02-26 |
| 1568883387 | Strengthening Teens, LLC | Foster Care Agency | 165 N 1330 W Ste A1, Orem, UT 84057-5116 | 2013-12-20 |
| 1285065854 | Terie Wiederhold | Foster Care Agency | 704 N Sr 51, Spanish Fork, UT 84660-1385 | 2013-12-09 |
| 1164857892 | Journey Counseling Center Sanpete LLC | Foster Care Agency | 41 W 700 S, Ephraim, UT 84627-1524 | 2013-09-12 |
| 1427397439 | Gene Steve Lopez | Foster Care Agency | 255 Flint St, Layton, UT 84041-3616 | 2013-02-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.