Provider Demographics
NPI:1457155285
Name:JOHNSON, KATHERINE MCDONALD
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MCDONALD
Last Name:JOHNSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 BALLENTRAE CT APT 209
Mailing Address - Street 2:
Mailing Address - City:PITTSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27312-5556
Mailing Address - Country:US
Mailing Address - Phone:919-809-2988
Mailing Address - Fax:
Practice Address - Street 1:136 WEST ST
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312-9470
Practice Address - Country:US
Practice Address - Phone:919-809-2988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty