MEDICARE: MRS. SASHA B 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
1	101YP2500X	Professional Counselor	0701008058	VA

General Provider Information

NPI Number	:	1689139230
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SASHA B JOHNSON LPC

Provider Business Mailing Address
First Line	:	PO BOX 7888
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23231-0388
Country	:	US
Telephone Number	:	804-901-1842
Fax Number	:	804-621-4231

Provider Business Practice Location Address
First Line	:	6601 IRONGATE SQ STE D
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23234-6077
Country	:	US
Telephone Number	:	804-901-1842
Fax Number	:	804-621-4231

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

Provider Enumeration Date	:	02/07/2019
Last Update Date	:	10/16/2024

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