Organization
JOURNEY BEHAVIORAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY R. MAZE (OFFICE MANAGER)
(337) 528-7992
Entity
Organization
Contact information
Practice address
423 CYPRESS ST., SULPHUR, LA 70663
(337) 528-7992
(337) 528-7994
Mailing address
423 CYPRESS ST., SULPHUR, LA 70663
(337) 528-7992
(337) 528-7994
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
2176
LA
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
8971
LA
2084P0800X
Psychiatry Physician
021615
LA
2084P0800X
Psychiatry Physician
—
—
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
05359
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1815713
—
LA
Enumeration date
01/13/2010
Last updated
11/05/2010
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