Organization
DIVINE MIND THERAPEUTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON JOHNSON LPC-LCPC-MFT (COO)
(202) 766-4216
Entity
Organization
Contact information
Practice address
1806 SUMMIT AVE SET 300 PMB 2034, RICHMOND, VA 23230
(571) 249-2519
Mailing address
2901 CONNECTICUT AVE NW APT B2, WASHINGTON, DC 20008-1451
(202) 766-4216
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/10/2022
Last updated
08/10/2022
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