MEDICARE: MS. HELENA ALEXIS JOHNSON LMFT-2014

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	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1871849653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HELENA ALEXIS JOHNSON LMFT-2014

Provider Business Mailing Address
First Line	:	5114 THORNTON KNOLL WAY
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27616-8045
Country	:	US
Telephone Number	:	814-659-2285
Fax Number	:

Provider Business Practice Location Address
First Line	:	5114 THORNTON KNOLL WAY
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27616-8045
Country	:	US
Telephone Number	:	814-659-2285
Fax Number	:	984-231-2925

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

Provider Enumeration Date	:	07/30/2012
Last Update Date	:	05/03/2023

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