Provider Demographics
NPI:1649834326
Name:JOHNSON, RAYSHAUN (LPC, NCC)
Entity type:Individual
Prefix:MR
First Name:RAYSHAUN
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:738 HARVARD ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-3810
Mailing Address - Country:US
Mailing Address - Phone:202-227-9455
Mailing Address - Fax:202-217-2230
Practice Address - Street 1:2001 L ST NW STE 500
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-4955
Practice Address - Country:US
Practice Address - Phone:202-227-9455
Practice Address - Fax:202-217-2230
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-27
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC14998101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE