Individual
TALISSA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, LMHP
Contact information
Practice address
751 BAYOU PINES EAST DR STE C, LAKE CHARLES, LA 70601-7196
(337) 433-3292
(337) 433-3293
Mailing address
1000 CHINABERRY DR STE 900, BOSSIER CITY, LA 71111-2455
(318) 459-6795
(318) 626-5429
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
8989
LA
101YM0800X
Mental Health Counselor
PLPC-8989
LA
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
8989
LA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
07/12/2016
Last updated
06/30/2024
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