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General NPI Number Information
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NPI Number | 1649900069
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Entity Type | Individual
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Provider Name | JOSHUA TERRILL JOHNSON M.ED, LPC
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Gender | Male
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Dates
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Enumeration Date | 06/16/2022
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 10 GLENLAKE PKWY STE 130
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City | ATLANTA
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State | GA
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Zip | 30328-3495
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Country | US
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Telephone | 833-351-8255
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 24449
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City | NEW YORK
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State | NY
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Zip | 10087-0589
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Country | US
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Telephone | 833-351-8255
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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 | PRC200001630
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 94048
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC013047
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License Number State | GA
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