Provider Demographics
NPI:1235707043
Name:JOHNSON, ALLISON (LPC)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:RENEE
Other - Last Name:SANDERFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:409 E MONTE CRISTO AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85022-3074
Mailing Address - Country:US
Mailing Address - Phone:480-274-8789
Mailing Address - Fax:
Practice Address - Street 1:7301 N 16TH ST STE 102
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-5266
Practice Address - Country:US
Practice Address - Phone:602-567-0263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-16
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-16161101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional