MEDICARE: KATHRYN JOHNSON LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	4703	TN

General Provider Information

NPI Number	:	1073101663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN JOHNSON LPC

Provider Business Mailing Address
First Line	:	9848 HOLLOW GLEN PL
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-1138
Country	:	US
Telephone Number	:	865-454-6667
Fax Number	:

Provider Business Practice Location Address
First Line	:	9848 HOLLOW GLEN PL
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-1138
Country	:	US
Telephone Number	:	865-454-6667
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2021
Last Update Date	:	01/08/2021

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Directions to “ KATHRYN JOHNSON LPC” Practice Location

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