Healthcare Provider Details

I. General information

NPI: 1871015842
Provider Name (Legal Business Name): VERONICA L JOHNSON LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2017
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 BRUNK RD
REISTERSTOWN MD
21136-2302
US

IV. Provider business mailing address

101 BRUNK RD
REISTERSTOWN MD
21136-2302
US

V. Phone/Fax

Practice location:
  • Phone: 443-929-0766
  • Fax:
Mailing address:
  • Phone: 443-929-0766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC9570
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: