Provider Demographics
NPI:1013241538
Name:JOHNSON, MARGO (MA, LPC, NBCC)
Entity Type:Individual
Prefix:
First Name:MARGO
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MA, LPC, NBCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 WEST MAIN STREET
Mailing Address - Street 2:SUITE 137
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-3408
Mailing Address - Country:US
Mailing Address - Phone:724-550-4404
Mailing Address - Fax:724-550-4521
Practice Address - Street 1:2 WEST MAIN STREET
Practice Address - Street 2:SUITE 137
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-3408
Practice Address - Country:US
Practice Address - Phone:724-550-4404
Practice Address - Fax:724-550-4521
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-30
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005306101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional