Individual
TRACEY LEANN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
125 S MAIN CROSS ST, LOUISA, KY 41230-1330
(606) 638-0938
(859) 813-5394
Mailing address
PO BOX 726, LOUISA, KY 41230-0726
(606) 638-0938
(859) 813-5394
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
104799
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000689192
ANTHEM BCBS
—
01
—
117986
CAQH
—
05
—
7100283500
—
KY
Enumeration date
01/21/2008
Last updated
12/05/2025
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