Provider Demographics
NPI:1265951040
Name:JOHNSON, ASHLEY PAIGE (LMFT)
Entity type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:PAIGE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2852 HOLLY GLEN DR APT H
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-8839
Mailing Address - Country:US
Mailing Address - Phone:252-714-9154
Mailing Address - Fax:
Practice Address - Street 1:205 MARTIN LUTHER KING JR. PARKWAY
Practice Address - Street 2:
Practice Address - City:SNOW HILL
Practice Address - State:NC
Practice Address - Zip Code:28580
Practice Address - Country:US
Practice Address - Phone:252-747-4199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-13
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12057A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist