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Individual

LAURA KATHRYN JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPCC, LMAC

Contact information

Practice address
2624 9TH AVE S, FARGO, ND 58103-2350
(701) 298-4500
Mailing address
1623 10TH ST W, WEST FARGO, ND 58078-3243
(314) 882-0790

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1766
ND
101YM0800X
Mental Health Counselor
Primary
731-9-15-12-259
ND

Other

Enumeration date
08/02/2016
Last updated
07/24/2024
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