MEDICARE: MRS. CANDACE NICHOLE JOHNSON MS,NCC,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	101YP2500X	Professional Counselor	PC009717	PA

General Provider Information

NPI Number	:	1528589330
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CANDACE NICHOLE JOHNSON MS,NCC,LPC

Provider Business Mailing Address
First Line	:	4755 LINGLESTOWN RD STE 206
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17112-8547
Country	:	US
Telephone Number	:	412-408-7482
Fax Number	:	717-796-5246

Provider Business Practice Location Address
First Line	:	4755 LINGLESTOWN RD STE 206
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17112-8547
Country	:	US
Telephone Number	:	412-408-7482
Fax Number	:	717-814-5260

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

Provider Enumeration Date	:	06/30/2017
Last Update Date	:	11/01/2024

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