Provider Demographics
NPI:1790109072
Name:JOHNSON, ERIKA (LPC)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
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 1:1365 GRAYLAND HILLS DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-8386
Mailing Address - Country:US
Mailing Address - Phone:770-630-3351
Mailing Address - Fax:
Practice Address - Street 1:4305 S LEE ST
Practice Address - Street 2:SUITE 400
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-5783
Practice Address - Country:US
Practice Address - Phone:770-630-3351
Practice Address - Fax:404-585-5004
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-07
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004049101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional