Provider Demographics
NPI:1851646244
Name:JOHNSON, CLARE CONWAY (LPC)
Entity Type:Individual
Prefix:MRS
First Name:CLARE
Middle Name:CONWAY
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 1:261 GREENGATE LN
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29307-2211
Mailing Address - Country:US
Mailing Address - Phone:864-778-5263
Mailing Address - Fax:864-448-1790
Practice Address - Street 1:200 FERNWOOD DR
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29307-2237
Practice Address - Country:US
Practice Address - Phone:864-778-5263
Practice Address - Fax:864-448-1790
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-20
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8087101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional