| Doctor Name: | ADDIE JOHNSON |
| NPI Number: | 1205188083 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | LC3268 |
| Business Practice Address: | 1811 Bethlehem Pike Suite 214-215 Flourtown, PA - 190311111 |
| Business Phone Number: | 2156430200 |
| Business Fax Number: | 2156439844 |
| Mailing Address: | 1811 Bethlehem Pike, Suite 214-215 FLOURTOWN |
| State: | PA |
| Postal Code: | 190311111 |
| Phone Number: | 2156430200 |
| Fax Number: | 2156439844 |
| NPI Enumeration Date: | 10/04/2012 |
| NPI Last Update Date: | 03/07/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | LC3268 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |