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General NPI Number Information
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NPI Number | 1649788316
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Entity Type | Organization
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Legal Business Name | JOHNSON COUNSELING AND FAMILY SERVICES, PLLC
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Dates
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Enumeration Date | 01/16/2018
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Last Update Date | 12/09/2019
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Provider Practice Location Address
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Address Line | 112 N CENTRAL AVE
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City | LANDIS
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State | NC
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Zip | 28088-1445
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Country | US
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Telephone | 704-741-0456
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Fax | 704-270-6223
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Provider Business Mailing Address
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Address Line | 112 N CENTRAL AVE
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City | LANDIS
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State | NC
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Zip | 28088-1445
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Country | US
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Telephone | 704-741-0456
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Fax | 704-270-6223
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MARTHA JOSEPH JOHNSON
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Credential | LPC
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Telephone | 704-425-3153
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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 | 7955
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License Number State | NC
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