Organization
JOURNEY TO SUCCESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REVA MINGO LPC, LADC (LICENSED PROFESSIONAL COUNSELOR)
(959) 245-4516
Entity
Organization
Contact information
Practice address
61 ARROW RD STE 103, WETHERSFIELD, CT 06109-1301
(959) 245-4516
Mailing address
61 ARROW RD STE 103, WETHERSFIELD, CT 06109-1301
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
—
—
Other
Enumeration date
04/14/2021
Last updated
05/18/2022
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