Provider Demographics
NPI:1841815222
Name:JOHNSON, BETTY N (MA COUNSELOR)
Entity type:Individual
Prefix:
First Name:BETTY
Middle Name:N
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MA COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 TAYLOR CIR
Mailing Address - Street 2:
Mailing Address - City:GROVETOWN
Mailing Address - State:GA
Mailing Address - Zip Code:30813-2218
Mailing Address - Country:US
Mailing Address - Phone:706-627-4795
Mailing Address - Fax:
Practice Address - Street 1:3351 WRIGHTSBORO RD STE 300
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-2800
Practice Address - Country:US
Practice Address - Phone:706-868-5011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-11
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor