Doctor Name: | MS. MEGAN JOHNSON |
NPI Number: | 1093947061 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCMHC, ASAC |
License Number: | 0689700557 |
Business Practice Address: | 15 Pinecrest Dr Essex Junction, VT - 054522912 |
Business Phone Number: | 8022881087 |
Business Fax Number: | 8028784404 |
Mailing Address: | 86 Lake St, BURLINGTON |
State: | VT |
Postal Code: | 054015297 |
Phone Number: | 8028653450 |
Fax Number: | |
NPI Enumeration Date: | 08/10/2009 |
NPI Last Update Date: | 08/10/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 0689700557 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |