Provider Demographics
NPI:1649788316
Name:JOHNSON COUNSELING AND FAMILY SERVICES, PLLC
Entity type:Organization
Organization Name:JOHNSON COUNSELING AND FAMILY SERVICES, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:704-425-3153
Mailing Address - Street 1:112 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:LANDIS
Mailing Address - State:NC
Mailing Address - Zip Code:28088-1445
Mailing Address - Country:US
Mailing Address - Phone:704-741-0456
Mailing Address - Fax:704-270-6223
Practice Address - Street 1:112 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:LANDIS
Practice Address - State:NC
Practice Address - Zip Code:28088-1445
Practice Address - Country:US
Practice Address - Phone:704-741-0456
Practice Address - Fax:704-270-6223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-16
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7955101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty