Individual
JUDE EDWIN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
5700 EXECUTIVE CENTER DR STE 110, CHARLOTTE, NC 28212-8833
(704) 525-3255
(704) 525-0949
Mailing address
350 PEE DEE AVE, ALBEMARLE, NC 28001-4932
(704) 986-1500
(800) 227-8961
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1166
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1166
LMFT
NC
05
—
6105168
—
NC
Enumeration date
03/06/2007
Last updated
12/20/2013
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