Provider Demographics
NPI:1093320731
Name:JOHNSON, AMBER LAUREN (LPC)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:LAUREN
Last Name:JOHNSON
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8133 RONDA DR
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-8929
Mailing Address - Country:US
Mailing Address - Phone:240-416-0732
Mailing Address - Fax:
Practice Address - Street 1:105 S CEDAR ST
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-6078
Practice Address - Country:US
Practice Address - Phone:843-212-6543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-10
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8398101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional