Provider Demographics
NPI:1346596988
Name:JOHNSON, RONDA SWANN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:RONDA
Middle Name:SWANN
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:PO BOX 1043
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35602-1043
Mailing Address - Country:US
Mailing Address - Phone:256-340-0300
Mailing Address - Fax:
Practice Address - Street 1:106 LEE ST NE
Practice Address - Street 2:SUITE C
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-1759
Practice Address - Country:US
Practice Address - Phone:256-340-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-01
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1585101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health