Organization · NPI-2

A Different Journey, LLC

Social Worker, Clinical · Brooklyn, NY

NPI number1235526443
StatusActive
Last updated in NPPESApr 26, 2015

Details

NPI
1235526443
Entity type
Organization (NPI-2)
Legal business name
A Different Journey, LLC
Organization subpart
No
Enumeration date
Apr 26, 2015
Last updated
Apr 26, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1041C0700X Social Worker, ClinicalR059610-1NYYes

Practice location

26 Court St Ste 1502
Brooklyn, NY 11242-1115

Phone 646-263-6227

Mailing address

134 Main Ave
Lake Grove, NY 11755-2000

Phone 646-263-6227

Authorized official

Vivian Stanford Thompson
Primary Therapist-Owner
6462636227

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