Provider Demographics
NPI:1033622675
Name:JOHNSON, ROYANN DARCINA (LPC)
Entity type:Individual
Prefix:
First Name:ROYANN
Middle Name:DARCINA
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 BERKSHIRE RD
Mailing Address - Street 2:STE 1 AND 2
Mailing Address - City:SANDY HOOK
Mailing Address - State:CT
Mailing Address - Zip Code:06482
Mailing Address - Country:US
Mailing Address - Phone:203-491-2577
Mailing Address - Fax:
Practice Address - Street 1:13 BERKSHIRE RD
Practice Address - Street 2:UNITS 1 & 2
Practice Address - City:SANDY HOOK
Practice Address - State:CT
Practice Address - Zip Code:06482-0648
Practice Address - Country:US
Practice Address - Phone:203-491-2577
Practice Address - Fax:203-491-2579
Is Sole Proprietor?:No
Enumeration Date:2017-11-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3314101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional