Organization Active NPI

Journeys of Life Therapeutic Resources,LLC

  • Professional Counselor
  • Rock Hill, SC
National Provider Identifier
1578912028
Registry record updated Jun 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5788 Issued in SC
Legal business name
JOURNEYS OF LIFE THERAPEUTIC RESOURCES,LLC
Practice address
2025 Ebenezer Rd Ste G
Rock Hill, SC 29732-1069
Phone
(704) 773-9003
NPI assigned
Jun 6, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2016

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

Authorized official

Name
Misty Brown Pearson, LPC
Title
Owner
Phone
(704) 773-9003

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 8236 NC
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 5788 SC Primary

Addresses

Primary practice location

2025 Ebenezer Rd Ste G
Rock Hill, SC 29732-1069

Mailing address

7043 Red Bud Cir
Charlotte, NC 28214-9324
Phone (704) 773-9003

Other identifiers 1

IdentifierTypeStateIssuer
PC1428MedicaidSC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465171200000",
    "number": "1578912028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7043 RED BUD CIR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282149324",
            "telephone_number": "704-773-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 EBENEZER RD STE G",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321069",
            "telephone_number": "704-773-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOURNEYS OF LIFE THERAPEUTIC RESOURCES,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-06",
        "last_updated": "2016-06-06",
        "status": "A",
        "authorized_official_last_name": "BROWN PEARSON",
        "authorized_official_first_name": "MISTY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-773-9003",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "8236",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "5788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PC1428",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.