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Kelly C. Johnson Lcsw, P.l.l.c.
Adolescent and Children Mental Health Clinic/Center in Durham, North Carolina
NPI 1205482460

Kelly C. Johnson Lcsw, P.l.l.c. is an Adolescent and Children Mental Health Clinic/Center based in Durham, NC and is specialized in Adolescent and Children Mental Health. Kelly C. Johnson Lcsw, P.l.l.c. practices in Durham, NC. The NPI Number for Kelly C. Johnson Lcsw, P.l.l.c. is 1205482460 and holds a License No. (North Carolina).

The current practice location address for Kelly C. Johnson Lcsw, P.l.l.c. is 2530 Meridian Parkway, Durham, NC and can be reached out via phone at 919-437-6627 and via fax at 919-258-2490.

Location: 2530 Meridian Parkway, Durham, NC, 27713-5273
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1205482460
Provider Name
Kelly C. Johnson Lcsw, P.l.l.c.
Credential
Provider Entity Type
Organization
Address
2530 Meridian Parkway, Durham, NC, 27713-5273
Phone Number
919-437-6627
Fax Number
919-258-2490
Provider Enumeration Date
08/14/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
C012146 01 NC STATE LICENSE
149019599 01 IL STATE LICENSE
1427573476 01 NPI NUMBER
institution
Provider Business Practice Location Address Details
Address
2530 Meridian Parkway
City
Durham
State
North Carolina
Zip
27713-5273
Phone Number
919-437-6627
Fax Number
919-258-2490
person
Provider Business Mailing Address Details
Address
2530 Meridian Parkway
City
Durham
State
North Carolina
Zip
27713-5273
Phone Number
919-437-6627
Fax Number
919-258-2490
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adolescent and Children Mental Health
Taxonomy
261QM0855X
License No.
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Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
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