Healthcare Provider Details

I. General information

NPI: 1841122884
Provider Name (Legal Business Name): CHARITY SITES JOHNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 SE 29TH PL STE 200
OCALA FL
34471-0486
US

IV. Provider business mailing address

310 SE 29TH PL STE 200
OCALA FL
34471-0486
US

V. Phone/Fax

Practice location:
  • Phone: 352-209-3513
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: