Individual provider · Type 1 NPI
Mark Carroll Johnson Sr., LMFT
Mental Health Counselor · New Milford, CT
NPI number
1760555437
Active
Practice location
35 Park Lane Rd
New Milford, CT 06776-2916
Fax (860) 354-4238
Mailing address
187 Aspetuck Ridge Rd
New Milford, CT 06776-5613
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | 000912 (CT) |
Mental Health Counselor: Definition to come...
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About NPI 1760555437
Mark Carroll Johnson Sr., LMFT's National Provider Identifier is 1760555437, issued on Nov 17, 2006. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in New Milford, CT. The record was last updated on Jul 8, 2007.