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NPI Code Detail

MEDICARE: ANGELA MARIE JOHNSON LPC

MEDICARE: ANGELA MARIE JOHNSON LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor3003-125WI

General Provider Information

NPI Number : 1184631558
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELA MARIE JOHNSON LPC
Provider Business Mailing Address
First Line : 16535 W BLUEMOUND RD STE 200
Second Line :
City : BROOKFIELD
State : WI
Zip : 53005-5906
Country : US
Telephone Number : 262-789-1191
Fax Number : 262-821-6180
Provider Business Practice Location Address
First Line : 16535 W BLUEMOUND RD STE 200
Second Line :
City : BROOKFIELD
State : WI
Zip : 53005-5906
Country : US
Telephone Number : 262-789-1191
Fax Number : 262-821-6180
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2006
Last Update Date : 10/07/2024

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Directions to “ ANGELA MARIE JOHNSON LPC” Practice Location

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