Provider Demographics
NPI:1235590480
Name:JOHNSON, GIANNINA FIGUEROA (LPCMH)
Entity Type:Individual
Prefix:
First Name:GIANNINA
Middle Name:FIGUEROA
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LPCMH
Other - Prefix:
Other - First Name:GIANNINA
Other - Middle Name:
Other - Last Name:FIGUEROA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPCMH
Mailing Address - Street 1:4023 KENNETT PIKE STE 56017
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:DE
Mailing Address - Zip Code:19807-2018
Mailing Address - Country:US
Mailing Address - Phone:302-314-5677
Mailing Address - Fax:
Practice Address - Street 1:4023 KENNETT PIKE STE 56017
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:DE
Practice Address - Zip Code:19807-2018
Practice Address - Country:US
Practice Address - Phone:302-314-5677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-16
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000851101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional