| The Journey Behavioral & Wellness Clinic, Llc | |
|
1456 Ebenezer Rd Rock Hill SC 29732-2339 | |
| (803) 693-6100 | |
| (803) 746-0923 |
| Full Name | The Journey Behavioral & Wellness Clinic, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1456 Ebenezer Rd, Rock Hill, South Carolina |
| Authorized Official Name and Position | Jennifer Turbeville Stutts (OWNER) |
| Authorized Official Contact | 8436876768 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Journey Behavioral & Wellness Clinic, Llc 5825 Castlecove Rd Charlotte NC 28273-0500 Ph: (843) 687-6768 | The Journey Behavioral & Wellness Clinic, Llc 1456 Ebenezer Rd Rock Hill SC 29732-2339 Ph: (803) 693-6100 |
| NPI Number | 1902450737 |
|---|---|
| Provider Enumeration Date | 07/30/2019 |
| Last Update Date | 10/15/2020 |
| Certification Date | 10/15/2020 |
| Medicare PECOS PAC ID | 4688004138 |
|---|---|
| Medicare Enrollment ID | O20200423002026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902450737 | NPI | - | NPPES |
| 19275 | Other | SC | SC LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Jennifer T Stutts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881084192 PECOS PAC ID: 1052630266 Enrollment ID: I20150508001340 |
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