Healthcare Provider Details

I. General information

NPI: 1023930419
Provider Name (Legal Business Name): CATHERINE YVONNE JOHNSON RMCHI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 SUTTON ST
ROCKLEDGE FL
32955-2463
US

IV. Provider business mailing address

23 SUTTON ST
ROCKLEDGE FL
32955-2463
US

V. Phone/Fax

Practice location:
  • Phone: 321-544-8541
  • Fax:
Mailing address:
  • Phone: 321-544-8541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number29053
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: