Provider Demographics
NPI:1134744964
Name:AMBER M JOHNSON LLC
Entity type:Organization
Organization Name:AMBER M JOHNSON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:304-910-1589
Mailing Address - Street 1:4207 PARLIAMENT DR STE B
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-2720
Mailing Address - Country:US
Mailing Address - Phone:304-910-1589
Mailing Address - Fax:318-787-6818
Practice Address - Street 1:4207 PARLIAMENT DR STE B
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-2720
Practice Address - Country:US
Practice Address - Phone:304-910-1589
Practice Address - Fax:318-787-6818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-08
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health