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Individual

DR. JAKE A JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DOCTORATE

Contact information

Practice address
14300 GALLANT FOX LN, SUITE 211, BOWIE, MD 20715-4003
(301) 262-2828
(301) 262-7637
Mailing address
6111 BEDDINGFIELD CT, CENTREVILLE, VA 20121-5318
(703) 502-1029
(301) 262-7637

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
297
MD
101YP2500X
Professional Counselor
Primary
297
MD

Other

Enumeration date
06/07/2007
Last updated
09/11/2025
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