Healthcare Provider Details

I. General information

NPI: 1932027810
Provider Name (Legal Business Name): BETSY JOHNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

715 COUNTRY CLUB CT
MOREHEAD CITY NC
28557-3147
US

IV. Provider business mailing address

715 COUNTRY CLUB CT
MOREHEAD CITY NC
28557-3147
US

V. Phone/Fax

Practice location:
  • Phone: 919-606-0062
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA22588
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: