Provider Demographics
NPI:1447315288
Name:JOHNSON, KAREN S (LPC, LCPC, LCMFT, LM)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:S
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LPC, LCPC, LCMFT, LM
Other - Prefix:MS
Other - First Name:KAREN
Other - Middle Name:S
Other - Last Name:JOHNSON GEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:14300 CHERRY LANE CT STE 203
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4979
Mailing Address - Country:US
Mailing Address - Phone:240-360-2647
Mailing Address - Fax:757-240-5936
Practice Address - Street 1:14300 CHERRY LANE CT STE 203
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707
Practice Address - Country:US
Practice Address - Phone:240-360-2647
Practice Address - Fax:757-240-5936
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002130101Y00000X, 101YP2500X
VA0717000984101YP2500X
MDLC6230101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010060346Medicaid