Provider Demographics
NPI:1447980867
Name:JJOHNSON BEHAVIORAL HEALTH & CONSULTING GROUP
Entity type:Organization
Organization Name:JJOHNSON BEHAVIORAL HEALTH & CONSULTING GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:TERRILL
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MED, NCC , LPC
Authorized Official - Phone:601-813-7168
Mailing Address - Street 1:PO BOX 1537
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:GA
Mailing Address - Zip Code:30268-7537
Mailing Address - Country:US
Mailing Address - Phone:601-813-7168
Mailing Address - Fax:
Practice Address - Street 1:531 CARLTON POINTE DR
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:GA
Practice Address - Zip Code:30268-2351
Practice Address - Country:US
Practice Address - Phone:601-813-7168
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-16
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health