Organization
KELLY C. JOHNSON LCSW, P.L.L.C.
Active
Other names
A New Chapter Counseling Services
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY C JOHNSON LCSW (MEMBER)
(919) 437-6627
Entity
Organization
Contact information
Practice address
2530 MERIDIAN PARKWAY, SUITE 300, PBN: 3071, DURHAM, NC 27713-5273
(919) 437-6627
(919) 258-2490
Mailing address
2530 MERIDIAN PARKWAY, SUITE 300, PBN: 3071, DURHAM, NC 27713-5273
(919) 437-6627
(919) 258-2490
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1427573476
NPI NUMBER
—
01
—
149019599
STATE LICENSE
IL
01
—
C012146
STATE LICENSE
NC
Enumeration date
08/14/2019
Last updated
08/14/2019
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