Provider Demographics
NPI:1407251507
Name:JOHNSON, DEANNE (LPC)
Entity Type:Individual
Prefix:MISS
First Name:DEANNE
Middle Name:
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 1:9708 HELLINGLY PL
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY VILLAGE
Mailing Address - State:MD
Mailing Address - Zip Code:20886-0580
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3029 MARTIN LUTHER KING JR AVE SE
Practice Address - Street 2:3RD FL
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-2506
Practice Address - Country:US
Practice Address - Phone:202-971-4051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-31
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC144901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical