Provider Demographics
NPI:1891553103
Name:JOHNSON SALAZAR, ANNIE ELIZABETH (MHS, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:ANNIE
Middle Name:ELIZABETH
Last Name:JOHNSON SALAZAR
Suffix:
Gender:F
Credentials:MHS, LPC, NCC
Other - Prefix:
Other - First Name:ANNIE
Other - Middle Name:ELIZABETH
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6212 PINERIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301
Mailing Address - Country:US
Mailing Address - Phone:318-446-1300
Mailing Address - Fax:
Practice Address - Street 1:1516 ALBERT ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301
Practice Address - Country:US
Practice Address - Phone:318-319-6461
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8768101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health