Individual
CHRYSTAL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3527 N ROLLING RD STE 7, WINDSOR MILL, MD 21244-2256
(443) 272-7158
Mailing address
4234 HUNTSHIRE RD, RANDALLSTOWN, MD 21133-4067
(443) 272-7158
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
211211926
MD
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
211211929
MD
101YM0800X
Mental Health Counselor
211211926
MD
101YP1600X
Pastoral Counselor
10148
MD
101YP2500X
Professional Counselor
211211928
MD
Other
Enumeration date
02/09/2022
Last updated
02/09/2022
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