Provider Demographics
NPI:1457351603
Name:JOHNSON, ROSANNE G (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ROSANNE
Middle Name:G
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:ROSANNE
Other - Middle Name:G
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8237 THOURON AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19150-2018
Mailing Address - Country:US
Mailing Address - Phone:717-602-9023
Mailing Address - Fax:
Practice Address - Street 1:160 S PROGRESS AVE #3A
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-4636
Practice Address - Country:US
Practice Address - Phone:717-473-0531
Practice Address - Fax:904-216-8269
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-29
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC001128101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional