Provider Demographics
NPI:1902273154
Name:JOHNSON, JULIA ANNE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:ANNE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 FRANKLIN ST
Mailing Address - Street 2:SUITE 226
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-2162
Mailing Address - Country:US
Mailing Address - Phone:276-638-0308
Mailing Address - Fax:276-638-0310
Practice Address - Street 1:300 FRANKLIN ST
Practice Address - Street 2:SUITE 226
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-2162
Practice Address - Country:US
Practice Address - Phone:276-638-0308
Practice Address - Fax:276-638-0310
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-24
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701006180101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional