Healthcare Provider Details

I. General information

NPI: 1588286959
Provider Name (Legal Business Name): EMILY G JOHNSON LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2020
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 MADISON RD
WALNUT HILLS OH
45206-1706
US

IV. Provider business mailing address

1501 ALEXANDRIA PIKE STE 103
FORT THOMAS KY
41075-2561
US

V. Phone/Fax

Practice location:
  • Phone: 513-354-5200
  • Fax:
Mailing address:
  • Phone: 513-283-9395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number293610
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: