Active NPI
Journey 4 Self LLC
- Clinical Social Worker
- Sidney, OH
National Provider Identifier
1720560907
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Legal business name
- JOURNEY 4 SELF LLC
- Practice address
- 121 E North St
Sidney, OH 45365-2709 - Phone
- (973) 902-2183
- Fax
- (937) 963-0932
- NPI assigned
- Sep 4, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mary Jean Carpenter, MSW, LISW
- Title
- Owner
- Phone
- (937) 902-2183
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
121 E North St
Sidney, OH 45365-2709
Mailing address
2338 Aldrin Dr
Sidney, OH 45365-1510
Phone (937) 902-2183
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
National Provider Directory
National Provider Directory- Tax ID family
- Journey 4 Self LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Sidney, OH
- NPI 1215796933
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Social Worker
- Sidney, OH
- NPI 1750881660
-
- Psychiatric/Mental Health Nurse Practitioner
- Youngstown, OH
- NPI 1205670080
Single Specialty
-
- Marriage & Family Therapist
- Sidney, OH
- NPI 1548031701
-
- Clinical Social Worker
- Sidney, OH
- NPI 1609462274
-
- Social Worker
- Sidney, OH
- NPI 1114736980
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536019200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1710460800000",
"number": "1720560907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2338 ALDRIN DR",
"city": "SIDNEY",
"state": "OH",
"postal_code": "453651510",
"telephone_number": "937-902-2183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 E NORTH ST",
"city": "SIDNEY",
"state": "OH",
"postal_code": "453652709",
"telephone_number": "973-902-2183",
"fax_number": "937-963-0932"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "JOURNEY 4 SELF LLC",
"organizational_subpart": "NO",
"enumeration_date": "2018-09-04",
"last_updated": "2024-03-15",
"certification_date": "2024-03-15",
"status": "A",
"authorized_official_last_name": "CARPENTER",
"authorized_official_first_name": "MARY JEAN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "937-902-2183",
"authorized_official_credential": "MSW, LISW"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sidney, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; 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.