Individual
MRS. KANISHA NATHASHA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
2000 PARK ST, COLUMBIA, SC 29201-2011
(803) 386-8834
Mailing address
264 KINGS CV, LOCUST GROVE, GA 30248-3904
(347) 205-7479
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
9956
SC
Other
Enumeration date
08/15/2018
Last updated
04/03/2025
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