Healthcare Provider Details

I. General information

NPI: 1922490234
Provider Name (Legal Business Name): FELESHA JOHNSON LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2015
Last Update Date: 02/21/2026
Certification Date: 02/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3808 BEDFORD DR
NORTH BEACH MD
20714-4046
US

IV. Provider business mailing address

3808 BEDFORD DR
NORTH BEACH MD
20714-4046
US

V. Phone/Fax

Practice location:
  • Phone: 240-478-9823
  • Fax:
Mailing address:
  • Phone: 240-478-9823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC7552
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: