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NPI Code Detail

MEDICARE: VIVECA JOHNSON LPC

MEDICARE: VIVECA 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 Counselor5583LA

General Provider Information

NPI Number : 1184978561
Entity Type Code : Individual
Provider Name (Legal Business Name) : VIVECA JOHNSON LPC
Provider Business Mailing Address
First Line : 2435 DRUSILLA LN STE F
Second Line :
City : BATON ROUGE
State : LA
Zip : 70809-1444
Country : US
Telephone Number : 225-508-3253
Fax Number : 225-647-3167
Provider Business Practice Location Address
First Line : 2435 DRUSILLA LN STE F
Second Line :
City : BATON ROUGE
State : LA
Zip : 70809-1444
Country : US
Telephone Number : 225-508-3253
Fax Number : 225-647-3167
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2012
Last Update Date : 01/20/2021

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