Provider Demographics
NPI:1164018271
Name:YOUR JOURNEY COUNSELING SERVICES
Entity type:Organization
Organization Name:YOUR JOURNEY COUNSELING SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:CORINNE
Authorized Official - Last Name:STADLER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:541-527-5774
Mailing Address - Street 1:1214 NW HELMHOLTZ WAY
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-9339
Mailing Address - Country:US
Mailing Address - Phone:541-408-1084
Mailing Address - Fax:
Practice Address - Street 1:1214 NW HELMHOLTZ WAY
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-9339
Practice Address - Country:US
Practice Address - Phone:541-408-1084
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-14
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty