Doctor Name: | DR. ROSALYN I JOHNSON |
NPI Number: | 1639505746 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ED.D., LMHC |
License Number: | MH 12044 |
Business Practice Address: | 2020 Talley Rd Leesburg, FL - 347483426 |
Business Phone Number: | 3523157800 |
Business Fax Number: | 3523606582 |
Mailing Address: | 797 Teague Trl, Apt 10-303 LADY LAKE |
State: | FL |
Postal Code: | 321593110 |
Phone Number: | 3523157800 |
Fax Number: | 3523606582 |
NPI Enumeration Date: | 09/20/2013 |
NPI Last Update Date: | 02/25/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | MH 12044 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |