Provider Demographics
NPI:1407665466
Name:JOHNSON, MAGDALENA (LMFT)
Entity type:Individual
Prefix:
First Name:MAGDALENA
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 CLEARSPRING DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-9644
Mailing Address - Country:US
Mailing Address - Phone:805-350-8949
Mailing Address - Fax:
Practice Address - Street 1:349 FOLLY RD STE 2B
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-2508
Practice Address - Country:US
Practice Address - Phone:843-608-9659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-04
Last Update Date:2025-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLMFT8203106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist