Provider Demographics
NPI:1487190229
Name:JOHANSSON COUNSELING
Entity Type:Organization
Organization Name:JOHANSSON COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:ECKBERG
Authorized Official - Last Name:JOHANSSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC/MHSP-T
Authorized Official - Phone:615-415-4464
Mailing Address - Street 1:1305 FORREST OAKS CT N
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-3963
Mailing Address - Country:US
Mailing Address - Phone:615-415-4464
Mailing Address - Fax:
Practice Address - Street 1:1305 FORREST OAKS CT N
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-3963
Practice Address - Country:US
Practice Address - Phone:615-415-4464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-18
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3800251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health