Individual
COLIN MAURICE JOHNSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.P.C. LCAS CSI
Contact information
Practice address
1000 N 1ST ST, ALBEMARLE, NC 28001-2833
(704) 983-2117
Mailing address
284 EXECUTIVE PARK DR, SUITE 100, CONCORD, NC 28025-1831
(704) 939-1100
(704) 939-1173
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1464
NC
101YP2500X
Professional Counselor
Primary
3775
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6103433
—
NC
Enumeration date
12/07/2006
Last updated
07/24/2013
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