Provider Demographics
NPI:1619458759
Name:JOHNSON, LAURA I (LPC)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:I
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7760 SHRADER RD
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23228-2552
Mailing Address - Country:US
Mailing Address - Phone:804-591-0002
Mailing Address - Fax:833-449-5204
Practice Address - Street 1:7760 SHRADER RD
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23228-2552
Practice Address - Country:US
Practice Address - Phone:804-591-0002
Practice Address - Fax:833-449-5204
Is Sole Proprietor?:No
Enumeration Date:2018-08-27
Last Update Date:2025-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALMHC10000046101YM0800X
VA0701015032101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health