Doctor Name: | TAKEA JOHNSON |
NPI Number: | 1679982912 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCPC |
License Number: | LGP5530 |
Business Practice Address: | 8258 Veterans Hwy Suite 13 Millersville, MD - 211081457 |
Business Phone Number: | 4107686088 |
Business Fax Number: | 4107686444 |
Mailing Address: | 7932 Silver Leaf Ct Apt A, GLEN BURNIE |
State: | MD |
Postal Code: | 210616031 |
Phone Number: | 4433063394 |
Fax Number: | 4106261922 |
NPI Enumeration Date: | 08/12/2014 |
NPI Last Update Date: | 02/29/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | LGP5530 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MD |
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 |