Provider Demographics
NPI:1407498363
Name:JOHNSON, JO ANNA (LPC)
Entity Type:Individual
Prefix:
First Name:JO
Middle Name:ANNA
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 1:750 DOWNTOWNER BLVD FL 3
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-5457
Mailing Address - Country:US
Mailing Address - Phone:251-591-2997
Mailing Address - Fax:
Practice Address - Street 1:750 DOWNTOWNER BLVD FL 3
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-5457
Practice Address - Country:US
Practice Address - Phone:251-591-2997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-11
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4156101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor