Individual
CHARLES D JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
402 SOUTH SILVER SPRINGS ROAD, CAPE GIRARDEAU, MO 63703
(573) 334-1100
(573) 334-8819
Mailing address
402 SOUTH SILVER SPRINGS ROAD, CAPE GIRARDEAU, MO 63703
(573) 334-1100
(573) 334-8819
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
000059
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
197666
BLUE CROSS BLUE SHIELD
MO
Enumeration date
10/04/2006
Last updated
07/08/2007
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