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General NPI Number Information
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NPI Number | 1508969668
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Entity Type | Individual
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Provider Name | SANDRA J JOHNSON LPC
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Gender | Female
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 29206 HIGHWAY 40 W # A12
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City | INDEPENDENCE
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State | LA
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Zip | 70443-3466
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Country | US
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Telephone | 985-286-3060
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1631
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City | INDEPENDENCE
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State | LA
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Zip | 70443-1631
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Country | US
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Telephone | 985-286-3060
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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 | 010183
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License Number State | GA
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