Provider Demographics
NPI:1437875069
Name:JOHNSON, ASHELON KARA (LCMHC)
Entity Type:Individual
Prefix:MRS
First Name:ASHELON
Middle Name:KARA
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14217 GRAND TRAVERSE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-9042
Mailing Address - Country:US
Mailing Address - Phone:864-991-2742
Mailing Address - Fax:
Practice Address - Street 1:14217 GRAND TRAVERSE DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28278-9042
Practice Address - Country:US
Practice Address - Phone:864-991-2742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-14
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12972101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty