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General NPI Number Information
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NPI Number | 1467235143
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Entity Type | Organization
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Legal Business Name | TL JOHNSON COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 08/16/2023
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Last Update Date | 08/16/2023
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Provider Practice Location Address
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Address Line | TRACEY JOHNSON 150 OAKLAND AVE. SUITE 200
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City | ROCK HILL
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State | SC
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Zip | 29730-4068
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Country | US
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Telephone | 803-334-4056
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 36144
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City | ROCK HILL
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State | SC
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Zip | 29732-0502
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Country | US
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Telephone | 803-334-4056
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TRACEY L JOHNSON
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Credential | LISW-CP
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Telephone | 803-334-4056
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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