Destination Life Llc-S
Destination Life Llc-S is a Clinical Social Worker in Ellisville, Mississippi. Works from 2 locations. Registered with an NPI since 2020.
- In the registry since
- 2020
- Specialties on file
- 15
Practice location Address checks out
7 Jonathan WayEllisville, MS 39437-5195
Phone: (817) 473-1312
Fax: (866) 990-2813
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Additional practice locations (1)
- 1759 Broad Park Cir S Ste 113, Mansfield, TX 76063-7836 — (817) 473-1312
Specialties & licences
| Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist (primary) | Taxonomy 364SP0807X |
|---|---|
| Clinical Social Worker | Taxonomy 1041C0700X |
| Child & Adolescent Psychiatric/Mental Health Registered Nurse | Taxonomy 163WP0807X |
| Occupational Therapist | Taxonomy 225X00000X |
| Mental Health Occupational Therapist | Taxonomy 225XM0800X |
| Primary Care Clinic/Center | Taxonomy 261QP2300X |
| Comprehensive Outpatient Rehabilitation Facility (CORF) | Taxonomy 261QR0401X |
| Clinical Medical Laboratory | Taxonomy 291U00000X |
| Nurse Practitioner | Taxonomy 363L00000X |
| Community Health Nurse Practitioner | Taxonomy 363LC1500X |
| Family Nurse Practitioner | Taxonomy 363LF0000X |
| Psychiatric/Mental Health Nurse Practitioner | Taxonomy 363LP0808X |
| Women's Health Nurse Practitioner | Taxonomy 363LW0102X |
| Clinical Nurse Specialist | Taxonomy 364S00000X |
| Psychiatric/Mental Health Clinical Nurse Specialist | Taxonomy 364SP0808X |
Record details
| NPI number | 1023625894 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Zemelda Carr — Adm · (817) 473-1312 |
| Other names | Sajourney |
| NPI enumerated | September 25, 2020 |
| Last updated in NPPES | July 30, 2021 |
| Certification date | July 30, 2021 |
| Mailing address | 2001 Se Green Oak Blvd Ste 130, Arlington, TX 76018-0952 |