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General NPI Number Information
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NPI Number | 1003393893
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Entity Type | Individual
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Provider Name | JUSTINE JOHNSON LPC
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Gender | Female
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Dates
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Enumeration Date | 07/24/2018
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Last Update Date | 01/09/2019
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Provider Practice Location Address
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Address Line | 6 PARK AVE
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City | FLEMINGTON
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State | NJ
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Zip | 08822-1319
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Country | US
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Telephone | 908-782-7905
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Fax | 908-782-5934
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Provider Business Mailing Address
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Address Line | 35 W MAIN ST
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City | HIGH BRIDGE
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State | NJ
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Zip | 08829-1803
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Country | US
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Telephone | 908-377-3908
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC00635000
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License Number State | NJ
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