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General NPI Number Information
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NPI Number | 1174802318
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Entity Type | Individual
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Provider Name | KARLIANN K JOHNSON LPCC
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Gender | Female
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Dates
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Enumeration Date | 08/05/2011
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Last Update Date | 10/20/2015
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Provider Practice Location Address
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Address Line | 1704 BELSLY BLVD
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City | MOORHEAD
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State | MN
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Zip | 56560-5274
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Country | US
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Telephone | 218-233-8068
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Fax |
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Provider Business Mailing Address
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Address Line | 862 36TH AVE E #211
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City | WEST FARGO
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State | ND
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Zip | 58078-7922
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Country | US
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Telephone | 218-831-1304
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 692-7-15-11-242
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 1076
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License Number State | MN
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