Gabrielle Johnson, LGPC

Individual provider Active NPI Professional Counselor · Accokeek, MD

NPI 1003694936 · NPPES record last updated Sep 20, 2023

Key facts

NPI
1003694936
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
LGP13549 (MD)
Practice address
801 Naeve CT
Accokeek, MD 20607-2290
Phone
(804) 943-2316
NPI assigned
Sep 20, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LGP13549MDMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LGP13549 MD Yes

Addresses

Primary practice location

801 Naeve CT
Accokeek, MD 20607-2290

Mailing address

2670 Crain Hwy Ste 501
Waldorf, MD 20601-2819
Phone (804) 943-2316

Other providers in Accokeek, MD

All providers in Accokeek, MD · Professional Counselor in Maryland

Sources for this page

Verify at the official NPI Registry.