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General NPI Number Information
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NPI Number | 1942722970
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Entity Type | Individual
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Provider Name | RON C JOHNSON LGPC, NCC
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Gender | Male
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Dates
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Enumeration Date | 07/11/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 11680 DOOLITTLE DR STE 103
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City | WALDORF
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State | MD
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Zip | 20602-3802
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Country | US
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Telephone | 240-607-2756
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Fax |
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Provider Business Mailing Address
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Address Line | 14208 SCHOOL LN
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City | UPPER MARLBORO
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State | MD
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Zip | 20772-2829
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Country | US
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Telephone | 540-419-1800
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LGPC00256
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LGP7904
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License Number State | MD
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