Provider Demographics
NPI:1417391921
Name:JOHNSON, ANGELA CHARLENE (LPC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:CHARLENE
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 1:1050 CONNECTICUT AVE NW
Mailing Address - Street 2:SUITE 500
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-5303
Mailing Address - Country:US
Mailing Address - Phone:202-527-9120
Mailing Address - Fax:
Practice Address - Street 1:1050 CONNECTICUT AVE NW
Practice Address - Street 2:SUITE 500
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-5303
Practice Address - Country:US
Practice Address - Phone:202-527-9120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-26
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC14740101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health