Provider Demographics
NPI:1407691769
Name:FERRANDJOHNSON, MARIA ANTOINETTE (PHD, MA, LPCA)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:ANTOINETTE
Last Name:FERRANDJOHNSON
Suffix:
Gender:F
Credentials:PHD, MA, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 STONEYWATER CT
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:SC
Mailing Address - Zip Code:29045-8010
Mailing Address - Country:US
Mailing Address - Phone:910-286-6171
Mailing Address - Fax:
Practice Address - Street 1:606 STONEYWATER CT
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:SC
Practice Address - Zip Code:29045-8010
Practice Address - Country:US
Practice Address - Phone:910-286-6171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-28
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCCOU.8822.PCI101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health