Individual
ADDIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1811 BETHLEHEM PIKE, SUITE 214-215, FLOURTOWN, PA 19031-1111
(215) 643-0200
(215) 643-9844
Mailing address
1811 BETHLEHEM PIKE, SUITE 214-215, FLOURTOWN, PA 19031-1111
(215) 643-0200
(215) 643-9844
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PC 007726
PA
1041C0700X
Clinical Social Worker
LC3268
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12751349
CAQH
PA
05
—
1303414
—
MA
Enumeration date
10/04/2012
Last updated
03/07/2016
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