Provider Demographics
NPI:1962642439
Name:JOHNSON, LINDA S (MA, LPA, HSP-PA)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:S
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MA, LPA, HSP-PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 2ND AVE NW
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-4944
Mailing Address - Country:US
Mailing Address - Phone:828-328-4313
Mailing Address - Fax:828-328-4820
Practice Address - Street 1:326 2ND AVE NW
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-4944
Practice Address - Country:US
Practice Address - Phone:828-328-4313
Practice Address - Fax:828-328-4820
Is Sole Proprietor?:No
Enumeration Date:2009-02-24
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3721103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist