Individual
LAKIA CHARISE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPES
Contact information
Practice address
230 AVONSHIRE DR, SUMMERVILLE, SC 29483-7355
(843) 697-7221
Mailing address
230 AVONSHIRE DR, SUMMERVILLE, SC 29483-7355
(843) 697-7221
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
4697
SC
251S00000X
Community/Behavioral Health Agency
4697
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LP1021
—
SC
Enumeration date
02/16/2018
Last updated
07/07/2020
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