Provider Demographics
NPI:1861036196
Name:J. DAWN JOHNSON, PSYD, PLLC
Entity Type:Organization
Organization Name:J. DAWN JOHNSON, PSYD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACQLYN
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:202-495-1581
Mailing Address - Street 1:1629 FRANCIS HAMMOND PKWY
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22302-3915
Mailing Address - Country:US
Mailing Address - Phone:202-487-1400
Mailing Address - Fax:
Practice Address - Street 1:1634 I ST NW STE 1200
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-4011
Practice Address - Country:US
Practice Address - Phone:202-495-1581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-30
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty