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General NPI Number Information
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NPI Number | 1881278448
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Entity Type | Individual
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Provider Name | TERRA JOHNSON LMHC
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Gender | Female
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Dates
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Enumeration Date | 05/10/2021
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Last Update Date | 05/10/2021
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Provider Practice Location Address
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Address Line | 2600 BENTLEY RD SE APT 313
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City | MARIETTA
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State | GA
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Zip | 30067-3200
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Country | US
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Telephone | 678-964-1868
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Fax | 949-561-4954
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Provider Business Mailing Address
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Address Line | 4065 PANOLA WOODS DR
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City | STONECREST
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State | GA
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Zip | 30038-3851
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Country | US
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Telephone | 678-964-1868
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Fax | 949-561-4954
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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 |
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License Number State |
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