Provider Demographics
NPI:1982257259
Name:JOHNSON, PRISCILLA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:PRISCILLA
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 MILL CREEK PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-1099
Mailing Address - Country:US
Mailing Address - Phone:757-800-3214
Mailing Address - Fax:757-966-2873
Practice Address - Street 1:111 MILL CREEK PKWY STE 201
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23323-1099
Practice Address - Country:US
Practice Address - Phone:757-800-3214
Practice Address - Fax:757-966-2873
Is Sole Proprietor?:No
Enumeration Date:2019-07-16
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701008493101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health