Individual
MR. TIMOTHY LEE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A., LCAS
Contact information
Practice address
3100 RHETT CT, CHARLOTTE, NC 28273-3660
(704) 579-0427
Mailing address
3100 RHETT CT, CHARLOTTE, NC 28273-3660
(704) 579-0427
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS 1659
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6112183
—
NC
Enumeration date
07/28/2010
Last updated
12/29/2010
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