Provider Demographics
NPI:1033510391
Name:JOURNEY RESOURCE CENTER LLC
Entity type:Organization
Organization Name:JOURNEY RESOURCE CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:662-760-0115
Mailing Address - Street 1:238 COUNTY ROAD 2446
Mailing Address - Street 2:
Mailing Address - City:GUNTOWN
Mailing Address - State:MS
Mailing Address - Zip Code:38849-9106
Mailing Address - Country:US
Mailing Address - Phone:662-760-0115
Mailing Address - Fax:662-596-0428
Practice Address - Street 1:2164 SOUTHRIDGE DR
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-6417
Practice Address - Country:US
Practice Address - Phone:660-760-0115
Practice Address - Fax:662-596-0428
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-05
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1923101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS1923OtherCOUNSELOR