Healing Your Journey Therapy, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34007827A Issued in IN

Legal business name

HEALING YOUR JOURNEY THERAPY, LLC

Practice address

509 W McKinley Ave Ste 3
Mishawaka, IN 46545-5564

Phone

(574) 319-1653

Fax

(574) 406-7966

NPI assigned

Jul 23, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Kimberly Dawn Delcourt, MSW, LCSWNPI 1285933812

Title

Sole Member/President

Phone

(574) 850-4267

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kimberly D Delcourt, MSW, LCSW

  • Clinical Social Worker
  • Mishawaka, IN
  • NPI 1285933812
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1532304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532304000000",
    "number": "1285111278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 DONMOYER AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466141864",
            "telephone_number": "574-319-1653",
            "fax_number": "574-406-7966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 W MCKINLEY AVE STE 3",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465455564",
            "telephone_number": "574-319-1653",
            "fax_number": "574-406-7966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALING YOUR JOURNEY THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-23",
        "last_updated": "2018-07-23",
        "status": "A",
        "authorized_official_last_name": "DELCOURT",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "SOLE MEMBER/PRESIDENT",
        "authorized_official_telephone_number": "574-850-4267",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007827A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mason P Haye, PA-C, ATC
• Christopher R Hays, PT, DPT
• Christopher Ryan Hazel, D.D.S.
• Douglas James Hazel, DDS
• Lindsay Nicole Hazelton
• Healthlinc Pharmacy LLC
• Healthlinc, Inc.
• Hearing Aid Service
• Heart to Heart Hospice of Northern Indiana LLC
• Heartsong Speech and Feeding, LLC

• Clinical Social Worker in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.