Provider Demographics
NPI:1891451464
Name:JOHNSON, JULIE LYNN (LMHCA)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:LYNN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9295 ILLAHEE RD NE
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98311-9365
Mailing Address - Country:US
Mailing Address - Phone:703-459-4929
Mailing Address - Fax:
Practice Address - Street 1:225 NW LINDVIG WAY STE 7
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-9090
Practice Address - Country:US
Practice Address - Phone:703-459-4929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61166219101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health