Provider Demographics
NPI:1457585838
Name:JOHNSON, FELICIA M (COUNSELOR)
Entity Type:Individual
Prefix:MS
First Name:FELICIA
Middle Name:M
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1324 W 126TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90044-1016
Mailing Address - Country:US
Mailing Address - Phone:323-839-7487
Mailing Address - Fax:
Practice Address - Street 1:1030 W FLORENCE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90044-2442
Practice Address - Country:US
Practice Address - Phone:323-750-7580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)