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NPI Code Detail

MEDICARE: MR. LAWRENCE LESTER JOHNSON II

MEDICARE:  MR. LAWRENCE LESTER JOHNSON II
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1902634108
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. LAWRENCE LESTER JOHNSON II
Provider Business Mailing Address
First Line : 253 CHANDLERS GLEN DR
Second Line :
City : BUNKER HILL
State : WV
Zip : 25413-2128
Country : US
Telephone Number : 540-664-0328
Fax Number :
Provider Business Practice Location Address
First Line : 253 CHANDLERS GLEN DR
Second Line :
City : BUNKER HILL
State : WV
Zip : 25413-2128
Country : US
Telephone Number : 540-664-0328
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2024
Last Update Date : 07/22/2024

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Directions to “ MR. LAWRENCE LESTER JOHNSON II ” Practice Location

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