Provider Demographics
NPI:1154605327
Name:JOHNSON, CATHERINE ANNE (COUNSELOR)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANNE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 SALEM ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801
Mailing Address - Country:US
Mailing Address - Phone:203-558-4513
Mailing Address - Fax:
Practice Address - Street 1:435 NEWBURY ST STE 214
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-1065
Practice Address - Country:US
Practice Address - Phone:203-558-4513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health