Individual
THOMAS JOHNSON SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
220 S HARRISON ST, EAST ORANGE, NJ 07018-1401
(973) 677-7053
Mailing address
220 S HARRISON ST, EAST ORANGE, NJ 07018-1401
(973) 677-7053
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2000623
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0314111
—
NJ
05
—
0314129
—
NJ
Enumeration date
05/19/2019
Last updated
05/20/2019
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