Provider Demographics
NPI:1083020002
Name:JOHNSON-SION, THERESA GAIL (PHD; LPC)
Entity Type:Individual
Prefix:DR
First Name:THERESA
Middle Name:GAIL
Last Name:JOHNSON-SION
Suffix:
Gender:F
Credentials:PHD; LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 VIRGINIA BEACH BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-4445
Mailing Address - Country:US
Mailing Address - Phone:757-729-4241
Mailing Address - Fax:757-200-6058
Practice Address - Street 1:3500 VIRGINIA BEACH BLVD STE 301
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-4445
Practice Address - Country:US
Practice Address - Phone:757-729-4241
Practice Address - Fax:757-200-6058
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-10
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003104101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional