Provider Demographics
NPI:1447771647
Name:JOHNSON, LINDA
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 NORTHLAND BLVD
Mailing Address - Street 2:STE 250
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-3221
Mailing Address - Country:US
Mailing Address - Phone:513-259-6174
Mailing Address - Fax:
Practice Address - Street 1:636 NORTHLAND BLVD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45240-3221
Practice Address - Country:US
Practice Address - Phone:513-259-6174
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health