Provider Demographics
NPI:1487041588
Name:JOHNSON, JOANNE M (LPC)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:M
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 1:187 WOODSTREAM BLVD # A
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22556-4629
Mailing Address - Country:US
Mailing Address - Phone:540-729-4104
Mailing Address - Fax:703-204-9001
Practice Address - Street 1:16712 JEFFERSON DAVIS HWY
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22026-2115
Practice Address - Country:US
Practice Address - Phone:855-417-2486
Practice Address - Fax:703-221-4115
Is Sole Proprietor?:No
Enumeration Date:2015-04-16
Last Update Date:2022-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005960101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0001210981OtherRN LICENSE