Organization Active NPI

Journey to Wellness Mental Health Services, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Gaithersburg, MD
National Provider Identifier
1679201719
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
JOURNEY TO WELLNESS MENTAL HEALTH SERVICES, LLC
Practice address
9711 Washingtonian Blvd Ste 550
Gaithersburg, MD 20878-5789
Phone
(240) 255-9804
Fax
(240) 348-8923
NPI assigned
Aug 8, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2022

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

Authorized official

Name
Dr. Ciara Michelle Smith, DNP, CRNP
Title
Pmhnp-BC
Phone
(240) 255-9804

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

9711 Washingtonian Blvd Ste 550
Gaithersburg, MD 20878-5789

Mailing address

9711 Washingtonian Blvd Ste 550
Gaithersburg, MD 20878-5789
Phone (240) 255-9804

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241126000220 DC Part B Supplier - Clinic/Group Practice 0042745275 Receives reassigned benefits from 2 practitioners
Practice locations: Gaithersburg, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659916800000",
    "number": "1679201719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9711 WASHINGTONIAN BLVD STE 550",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208785789",
            "telephone_number": "240-255-9804",
            "fax_number": "240-348-8923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9711 WASHINGTONIAN BLVD STE 550",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208785789",
            "telephone_number": "240-255-9804",
            "fax_number": "240-348-8923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOURNEY TO WELLNESS MENTAL HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-08",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CIARA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "PMHNP-BC",
        "authorized_official_telephone_number": "240-255-9804",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, CRNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; 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.