Provider Demographics
NPI:1144710161
Name:JOHNSON, SANDRA MARIA (LMHC)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:MARIA
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 CHAPMAN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-9384
Mailing Address - Country:US
Mailing Address - Phone:407-279-1970
Mailing Address - Fax:
Practice Address - Street 1:2572 W STATE ROAD 426 STE 1024
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-8312
Practice Address - Country:US
Practice Address - Phone:407-279-1970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-15
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health