Provider Demographics
NPI:1528382272
Name:JOHNSON, DAMIEN EDWARD (LPC)
Entity Type:Individual
Prefix:MR
First Name:DAMIEN
Middle Name:EDWARD
Last Name:JOHNSON
Suffix:
Gender:M
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:PO BOX 706
Mailing Address - Street 2:
Mailing Address - City:LAURINBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28353-0706
Mailing Address - Country:US
Mailing Address - Phone:910-277-2600
Mailing Address - Fax:910-277-6200
Practice Address - Street 1:118 JAMES ST
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-3824
Practice Address - Country:US
Practice Address - Phone:910-277-2600
Practice Address - Fax:910-277-6200
Is Sole Proprietor?:No
Enumeration Date:2010-03-24
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7860101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor