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General NPI Number Information
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NPI Number | 1609733716
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Entity Type | Individual
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Provider Name | DAN BERNARD JOHNSON JR. PH.D.
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Gender | Male
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Dates
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Enumeration Date | 01/08/2026
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 174 SCHOLAR RD
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City | GUYTON
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State | GA
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Zip | 31312-6240
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Country | US
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Telephone | 912-877-2227
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Fax | 912-877-2332
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Provider Business Mailing Address
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Address Line | 1912 COLONY PARK RD
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City | AUGUSTA
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State | GA
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Zip | 30909-4208
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Country | US
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Telephone | 706-589-3863
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | GA
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