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NPI Code Detail

MEDICARE: LYDIA JOHNSON

MEDICARE: LYDIA JOHNSON
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
1101YP2500XProfessional CounselorLPC007987GA

General Provider Information

NPI Number : 1932501939
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYDIA JOHNSON
Provider Business Mailing Address
First Line : 1050 CROWN POINTE PKWY STE 500
Second Line :
City : ATLANTA
State : GA
Zip : 30338-7702
Country : US
Telephone Number : 678-723-3864
Fax Number : 404-393-2506
Provider Business Practice Location Address
First Line : 1050 CROWN POINTE PKWY STE 500
Second Line :
City : ATLANTA
State : GA
Zip : 30338-7702
Country : US
Telephone Number : 678-723-3864
Fax Number : 404-393-2506
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2014
Last Update Date : 09/05/2023

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Directions to “ LYDIA JOHNSON ” Practice Location

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