MEDICARE: SHARON LEE JOHNSON PHD, M.ED, 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
1	101Y00000X	Counselor
2	101YP2500X	Professional Counselor	6401016054	MI
3	101Y00000X	Counselor	6401016054	MI

General Provider Information

NPI Number	:	1477184174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON LEE JOHNSON PHD, M.ED, LPC

Provider Business Mailing Address
First Line	:	100 CABANA CAY CIR UNIT 220
Second Line	:
City	:	PANAMA CITY BEACH
State	:	FL
Zip	:	32413-4664
Country	:	US
Telephone Number	:	734-255-8848
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 CABANA CAY CIR UNIT 220
Second Line	:
City	:	PANAMA CITY BEACH
State	:	FL
Zip	:	32413-4664
Country	:	US
Telephone Number	:	734-255-8848
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2020
Last Update Date	:	06/21/2024

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