NPIMap

Organization Active NPI

Journeys Counseling Center Inc.

  • Community/Behavioral Health Agency
  • Greensboro, NC
National Provider Identifier
1982907838
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
JOURNEYS COUNSELING CENTER INC.
Practice address
3405 W Wendover Ave Ste a
Greensboro, NC 27407-1525
Phone
(336) 294-1349
Fax
(336) 292-6711
NPI assigned
Dec 15, 2010
Last updated
Aug 30, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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

Authorized official

Name
Mrs. Shirena Simpson Smith, LCSW
Title
Owner
Phone
(336) 451-1113

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Professional Counselor 101YP2500X
Clinical Social Worker 1041C0700X
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

3405 W Wendover Ave Ste a
Greensboro, NC 27407-1525

Mailing address

612 Pasteur Dr Ste 400
Greensboro, NC 27403-1120
Phone (336) 294-1349

Other identifiers 2

IdentifierTypeStateIssuer
6008309MedicaidNC
6106778MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130916000307 NC Part B Supplier - Clinic/Group Practice 4789828682 Receives reassigned benefits from 6 practitioners
Practice locations: Greensboro, NC

National Provider Directory

National Provider Directory

Locations

3405 W Wendover Ave
Ste A
Greensboro, NC 27407
Phone (336) 235-2427

612 Pasteur Dr
Ste 300
Greensboro, NC 27403
Phone (336) 294-1349

612 Pasteur Dr
Ste 400
Greensboro, NC 27403
Phone (336) 294-1349

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1292371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661817600000",
    "number": "1982907838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 PASTEUR DR STE 400",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274031120",
            "telephone_number": "336-294-1349",
            "fax_number": "336-292-6711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3405 W WENDOVER AVE STE A",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274071525",
            "telephone_number": "336-294-1349",
            "fax_number": "336-292-6711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOURNEYS COUNSELING CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-15",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SHIRENA",
        "authorized_official_middle_name": "SIMPSON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "336-451-1113",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6008309",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6106778",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.