Provider Demographics
NPI:1689545279
Name:JOHNSON, CANDACE LYNNE (NCC)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:LYNNE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6190 POWERS FERRY RD STE 520
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-4450
Mailing Address - Country:US
Mailing Address - Phone:404-437-6075
Mailing Address - Fax:
Practice Address - Street 1:6190 POWERS FERRY RD STE 520
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-4450
Practice Address - Country:US
Practice Address - Phone:404-437-6075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-16
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional