Individual
MRS. AMY DALE MERCADO JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., LPC, NCC
Contact information
Practice address
711 EXECUTIVE PL, FAYETTEVILLE, NC 28305-5193
(910) 615-3750
Mailing address
711 EXECUTIVE PL FL 3, FAYETTEVILLE, NC 28305-5193
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8796
NC
101YM0800X
Mental Health Counselor
QS142206
NC
101YP2500X
Professional Counselor
8796
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6104912
—
NC
Enumeration date
10/27/2011
Last updated
05/06/2026
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