Healthcare Provider Details

I. General information

NPI: 1447315288
Provider Name (Legal Business Name): KAREN S JOHNSON LPC, LCPC, LCMFT, LM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN S JOHNSON GEE LPC

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 08/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14300 CHERRY LANE CT STE 203
LAUREL MD
20707
US

IV. Provider business mailing address

14300 CHERRY LANE CT STE 203
LAUREL MD
20707-4979
US

V. Phone/Fax

Practice location:
  • Phone: 240-360-2647
  • Fax: 757-240-5936
Mailing address:
  • Phone: 240-360-2647
  • Fax: 757-240-5936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number0701002130
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701002130
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0717000984
License Number StateVA
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC6230
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: