Provider Demographics
NPI:1316318629
Name:JOHNSON, JULIE (LPCC-S)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LPCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 COLE DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:43031-1089
Mailing Address - Country:US
Mailing Address - Phone:614-302-3435
Mailing Address - Fax:855-850-2337
Practice Address - Street 1:1075 BEECHER XING N STE C
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230
Practice Address - Country:US
Practice Address - Phone:614-831-0844
Practice Address - Fax:855-850-2337
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-13
Last Update Date:2018-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1100259101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional