Provider Demographics
NPI:1316973290
Name:JOHNSON, LINDA S (LPC, LBP)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:S
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LPC, LBP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7113 S LINN AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-2715
Mailing Address - Country:US
Mailing Address - Phone:405-681-8308
Mailing Address - Fax:405-681-4434
Practice Address - Street 1:7113 S LINN AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-2715
Practice Address - Country:US
Practice Address - Phone:405-681-8308
Practice Address - Fax:405-681-4434
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3124101Y00000X
OK0155101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor