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General NPI Number Information
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NPI Number | 1790033413
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Entity Type | Individual
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Provider Name | JANICE R JOHNSON LPC
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Gender | Female
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Dates
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Enumeration Date | 08/28/2012
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Last Update Date | 08/28/2012
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Provider Practice Location Address
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Address Line | 1435 CROSSWAYS BLVD SUITE 109
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City | CHESAPEAKE
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State | VA
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Zip | 23320-2896
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Country | US
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Telephone | 757-410-0072
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Fax | 747-410-7290
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Provider Business Mailing Address
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Address Line | 1609 SWAN LAKE CRES
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City | CHESAPEAKE
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State | VA
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Zip | 23321-1348
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Country | US
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Telephone | 757-642-4474
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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 | 0701005298
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License Number State | VA
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