Individual
MR. MILES CARLISLE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LPC
Contact information
Practice address
418A BARR RD, LEXINGTON, SC 29072-2363
(864) 280-7208
(803) 621-9061
Mailing address
508 SANDPINE RD, COLUMBIA, SC 29229-7629
(803) 463-9818
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
8025
SC
Other
Enumeration date
12/16/2020
Last updated
09/24/2024
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