Individual
MR. MARK CARROLL JOHNSON SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
35 PARK LANE RD, NEW MILFORD, CT 06776-2916
(860) 354-4135
(860) 354-4238
Mailing address
187 ASPETUCK RIDGE RD, NEW MILFORD, CT 06776-5613
(860) 354-4992
(860) 354-4238
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
000912
CT
Other
Enumeration date
11/17/2006
Last updated
07/08/2007
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