MEDICARE: BROOKE JOHNSON MA

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	101YM0800X	Mental Health Counselor	0701015877	VA

General Provider Information

NPI Number	:	1700739349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BROOKE JOHNSON MA

Provider Business Mailing Address
First Line	:	8134 OLD KEENE MILL RD STE 101
Second Line	:
City	:	SPRINGFIELD
State	:	VA
Zip	:	22152-1849
Country	:	US
Telephone Number	:	703-569-8731
Fax Number	:

Provider Business Practice Location Address
First Line	:	8134 OLD KEENE MILL RD STE 101
Second Line	:
City	:	SPRINGFIELD
State	:	VA
Zip	:	22152-1849
Country	:	US
Telephone Number	:	703-569-8731
Fax Number	:

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

Provider Enumeration Date	:	02/16/2026
Last Update Date	:	02/16/2026

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Directions to “ BROOKE JOHNSON MA” Practice Location

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