Healthcare Provider Details

I. General information

NPI: 1982560850
Provider Name (Legal Business Name): EUNMEE JOHNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7051 HEATHCOTE VILLAGE WAY STE 125
GAINESVILLE VA
20155-3198
US

IV. Provider business mailing address

44679 ENDICOTT DR # 3090
ASHBURN VA
20147-5567
US

V. Phone/Fax

Practice location:
  • Phone: 571-307-7577
  • Fax:
Mailing address:
  • Phone: 571-307-7577
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0701015465
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701015465
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: