Provider Demographics
NPI:1750933586
Name:JOHNSON, SARAH JOYANNA (PHD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:JOYANNA
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:JOYANNA
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:120 CLAY ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-1743
Mailing Address - Country:US
Mailing Address - Phone:910-470-5705
Mailing Address - Fax:
Practice Address - Street 1:30 MONUMENT SQ STE 212
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-1896
Practice Address - Country:US
Practice Address - Phone:617-661-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-11
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10000849103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical