Healthcare Provider Details

I. General information

NPI: 1558805945
Provider Name (Legal Business Name): RHONDA MARIA JOHNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2016
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10125 W COLONIAL DR STE 212
OCOEE FL
34761-4200
US

IV. Provider business mailing address

2055 SUGARLOAF CIR STE 575
DULUTH GA
30097-9804
US

V. Phone/Fax

Practice location:
  • Phone: 833-769-3524
  • Fax:
Mailing address:
  • Phone: 404-999-7971
  • Fax: 678-534-2045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH23014
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC015784
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: