Healthcare Provider Details

I. General information

NPI: 1588835672
Provider Name (Legal Business Name): JOHANNA ALVINA LIMMER MC LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JOHANNA ALVINA MOWATT MC LPC

II. Dates (important events)

Enumeration Date: 03/17/2008
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 S SHORE LN
RAPIDS CITY IL
61278-1002
US

IV. Provider business mailing address

PO BOX 105
RAPIDS CITY IL
61278-0105
US

V. Phone/Fax

Practice location:
  • Phone: 770-626-0510
  • Fax:
Mailing address:
  • Phone: 770-626-0510
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC008107
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: