MEDICARE: LEONIA JOHNSON LAPC

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	APC001815	PA

General Provider Information

NPI Number	:	1609695170
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEONIA JOHNSON LAPC

Provider Business Mailing Address
First Line	:	233 S MILLICK ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19139-3711
Country	:	US
Telephone Number	:	215-459-8126
Fax Number	:

Provider Business Practice Location Address
First Line	:	233 S MILLICK ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19139-3711
Country	:	US
Telephone Number	:	215-459-8126
Fax Number	:

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

Provider Enumeration Date	:	10/10/2024
Last Update Date	:	05/21/2026

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