| Healing Your Journey Therapy, Llc | |
|
509 W Mckinley Ave Ste 3 Mishawaka IN 46545-5564 | |
| (574) 319-1653 | |
| (574) 406-7966 |
| Full Name | Healing Your Journey Therapy, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 509 W Mckinley Ave Ste 3, Mishawaka, Indiana |
| Authorized Official Name and Position | Kimberly Dawn Delcourt (SOLE MEMBER/PRESIDENT) |
| Authorized Official Contact | 5748504267 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healing Your Journey Therapy, Llc 222 Donmoyer Ave South Bend IN 46614-1864 Ph: (574) 319-1653 | Healing Your Journey Therapy, Llc 509 W Mckinley Ave Ste 3 Mishawaka IN 46545-5564 Ph: (574) 319-1653 |
| NPI Number | 1285111278 |
|---|---|
| Provider Enumeration Date | 07/23/2018 |
| Last Update Date | 07/23/2018 |
| Medicare PECOS PAC ID | 6002164761 |
|---|---|
| Medicare Enrollment ID | O20180813001774 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285111278 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 34007827A (Indiana) | Primary |
| Provider Name | Kimberly Delcourt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285933812 PECOS PAC ID: 1052689767 Enrollment ID: I20170622000103 |
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