Individual
DR. CHERYL ANN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
278 W MILLBROOK RD, RALEIGH, NC 27609-4304
(919) 624-2621
Mailing address
278 W MILLBROOK RD, RALEIGH, NC 27609-4304
(919) 624-2621
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2876
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
086793
VALUE OPTIONS
NC
01
—
2876
NC PSYCHOLOGY BD LICENSE
NC
01
—
46389
BLUECROSSBLUESHIELD
NC
Enumeration date
01/11/2006
Last updated
11/19/2020
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