Provider Demographics
NPI:1538876685
Name:MIND YOUR JOURNEY COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:MIND YOUR JOURNEY COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTEONA
Authorized Official - Middle Name:
Authorized Official - Last Name:PITTS WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:256-469-8976
Mailing Address - Street 1:124 JAMIE LN
Mailing Address - Street 2:
Mailing Address - City:TONEY
Mailing Address - State:AL
Mailing Address - Zip Code:35773-9368
Mailing Address - Country:US
Mailing Address - Phone:601-573-9899
Mailing Address - Fax:
Practice Address - Street 1:8840 MADISON BLVD STE 200G
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-2622
Practice Address - Country:US
Practice Address - Phone:256-469-8976
Practice Address - Fax:203-816-6028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-28
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty