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Organization
JOURNEY WITHIN LLC
Active
Organization
JOURNEY WITHIN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORI ELLEN GORDON-MICHAELI LMSW (CLINICAL SOCIAL WORKER)
(248) 225-8240
Entity
Organization
Contact information
Practice address
29623 NORTHWESTERN HWY, SOUTHFIELD, MI 48034-1076
(248) 225-8240
Mailing address
26342 DUNDALK ST, FARMINGTON HILLS, MI 48334-4812
(248) 225-8240
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801095173
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0963822
BLUE CROSS
MI
Enumeration date
11/20/2016
Last updated
11/20/2016
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