Healthcare Provider Details

I. General information

NPI: 1497684880
Provider Name (Legal Business Name): JULIE L JOHNS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4505 COLUMBUS ST STE 200
VIRGINIA BEACH VA
23462-6781
US

IV. Provider business mailing address

4817 MICHAUX DR
VIRGINIA BEACH VA
23464-3142
US

V. Phone/Fax

Practice location:
  • Phone: 757-692-0368
  • Fax:
Mailing address:
  • Phone: 757-692-0368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0904020474
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: