Healthcare Provider Details

I. General information

NPI: 1205467206
Provider Name (Legal Business Name): ROBERT L JOHNSON MC, MCAP, CMHP, CST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2020
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2714 MARSH ELDER RD
CAMBRIDGE MD
21613-3411
US

IV. Provider business mailing address

2714 MARSH ELDER RD
CAMBRIDGE MD
21613-3411
US

V. Phone/Fax

Practice location:
  • Phone: 561-239-1822
  • Fax:
Mailing address:
  • Phone: 561-239-1822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: