Provider Demographics
NPI:1538830492
Name:JOHNSON, RACHELLE VICTORIA (LCPC)
Entity type:Individual
Prefix:
First Name:RACHELLE
Middle Name:VICTORIA
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:RACHELLE
Other - Middle Name:VICTORIA
Other - Last Name:SAPPINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:400 LIBERTY CT
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:21040-2216
Mailing Address - Country:US
Mailing Address - Phone:443-356-9239
Mailing Address - Fax:
Practice Address - Street 1:400 LIBERTY CT
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:MD
Practice Address - Zip Code:21040-2216
Practice Address - Country:US
Practice Address - Phone:443-356-9239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-21
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LC14180101YP2500X
MDLGP11791101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional