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Individual

ACACIA LYNETTE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
104 LOCK AND DAM RD, RUSSELLVILLE, AR 72802-9725
(479) 222-0268
Mailing address
104 LOCK AND DAM RD, RUSSELLVILLE, AR 72802-9725
(479) 747-5222

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
P1202014
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
175189795
AR
05
1912149618
AR
Enumeration date
03/27/2009
Last updated
10/14/2025
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