Provider Demographics
NPI:1720540362
Name:JOHNSON, LAURA BETH (LPC-MHSP)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:BETH
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:MISS
Other - First Name:LAURA
Other - Middle Name:BETH
Other - Last Name:POPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:595 OLD MCMINNVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:TN
Mailing Address - Zip Code:37190-0605
Mailing Address - Country:US
Mailing Address - Phone:615-788-0023
Mailing Address - Fax:
Practice Address - Street 1:2670 MEMORIAL BLVD STE D3
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-5134
Practice Address - Country:US
Practice Address - Phone:615-796-6658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-03
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000005430101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health