Individual
CARLY MICHELLE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1115 BROADWAY FL 11, NEW YORK, NY 10010-0058
(916) 764-4571
Mailing address
450 SUYDAM ST APT 2R, BROOKLYN, NY 11237-3484
(916) 764-4571
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/05/2025
Last updated
03/05/2025
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