Healthcare Provider Details

I. General information

NPI: 1093370579
Provider Name (Legal Business Name): ANGELA E JOHNSON MS, MA, LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2019
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2230 ROUTE 70 W STE 21201
CHERRY HILL NJ
08002-3338
US

IV. Provider business mailing address

2230 ROUTE 70 W STE 2
CHERRY HILL NJ
08002-3338
US

V. Phone/Fax

Practice location:
  • Phone: 609-200-6989
  • Fax:
Mailing address:
  • Phone: 609-200-6989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-15-09758
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37PC01151000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: