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Individual

MR. JOHNATHAN ANTHONY JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC-MHSP

Contact information

Practice address
1101 KERMIT DR STE 511, NASHVILLE, TN 37217-5110
(615) 601-0580
(615) 777-3360
Mailing address
1004 HICKORY HILL LN STE 3, HERMITAGE, TN 37076-1931
(615) 601-0580
(615) 777-3360

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2098
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1528040
TN
01
45-5143984
IRS
Enumeration date
02/06/2007
Last updated
12/04/2024
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