NPIMap

Organization Active NPI

Journey of Life Therapy, LLC

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1760121891
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
JOURNEY OF LIFE THERAPY, LLC
Practice address
625 Kenmoor Ave
Suite 301 PMB 92790
Grand Rapids, MI 49546
Phone
(616) 414-0983
NPI assigned
May 27, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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

Authorized official

Name
Heather Pajonk, LMSWNPI 1235644683
Title
Owner/Therapist
Phone
(616) 414-0983

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)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

625 Kenmoor Ave
Suite 301 PMB 92790
Grand Rapids, MI 49546

Mailing address

2222 W Grand River Ave Ste a
Okemos, MI 48864-1604

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1653609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654128000000",
    "number": "1760121891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 W GRAND RIVER AVE STE A",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488641604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 KENMOOR AVE",
            "address_2": "SUITE 301 PMB 92790",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49546",
            "telephone_number": "616-414-0983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOURNEY OF LIFE THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-27",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A",
        "authorized_official_last_name": "PAJONK",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "616-414-0983",
        "authorized_official_credential": "LMSW"
    },
    "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 Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; 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.