Organization
GROUNDWORK THERAPY PSYCHOLOGICAL SERVICES, PLLC
Active
Other names
Groundwork Therapy, PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA MORGAN JOHNSON PSYD (OWNER/MEMBER/CLINICAL PSYCHOLOGIST)
(714) 267-0471
Entity
Organization
Contact information
Practice address
1000 DEAN STREET,, SUITE 226, BROOKLYN, NY 11238
(347) 669-9792
Mailing address
1000 DEAN STREET,, SUITE 226, BROOKLYN, NY 11238
(347) 669-9792
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013167907
NPI
—
01
—
1093048753
NPI
—
Enumeration date
06/06/2018
Last updated
12/21/2018
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