Individual
CAROL S JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
630 HAINES AVE NW, ALBUQUERQUE, NM 87102-1226
(505) 268-5611
Mailing address
5 LANE LN, SHERIDAN, WY 82801-8630
(307) 675-4120
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
203
WY
106H00000X
Marriage & Family Therapist
310445
TN
106H00000X
Marriage & Family Therapist
578
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
98588290
—
NM
Enumeration date
03/06/2007
Last updated
02/03/2023
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