Provider Demographics
NPI:1225273378
Name:JOHNSON, WHITNEY BROOKE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:BROOKE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 N BOYLAN AVE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-1424
Mailing Address - Country:US
Mailing Address - Phone:919-607-0256
Mailing Address - Fax:
Practice Address - Street 1:219 N BOYLAN AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-1424
Practice Address - Country:US
Practice Address - Phone:919-607-0256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-03
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6504101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional