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General NPI Number Information
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NPI Number | 1114287349
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Entity Type | Individual
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Provider Name | BENJAMIN EVERETT JOHNSON M.A., PLPC, PLMFT
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Gender | Male
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Dates
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Enumeration Date | 05/22/2012
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Last Update Date | 07/31/2015
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Provider Practice Location Address
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Address Line | 1000 CLAY ST
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City | KENNER
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State | LA
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Zip | 70062-6734
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Country | US
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Telephone | 504-920-5319
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 929 ATTN: FAMILY PLUS
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City | RUSTON
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State | LA
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Zip | 71273-0929
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Country | US
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Telephone | 504-920-5319
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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 |
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State | LA
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