=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447315288
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KAREN S JOHNSON LPC, LCPC, LCMFT, LM
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/22/2006
-----------------------------------------------------
Last Update Date | 08/23/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14300 CHERRY LANE CT STE 203
-----------------------------------------------------
City | LAUREL
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20707
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-360-2647
-----------------------------------------------------
Fax | 757-240-5936
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14300 CHERRY LANE CT STE 203
-----------------------------------------------------
City | LAUREL
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20707-4979
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-360-2647
-----------------------------------------------------
Fax | 757-240-5936
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number | 0701002130
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 0701002130
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 0717000984
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | LC6230
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------