Johansen, Susan Bragdon
Johansen, Susan Bragdon is an individual health care provider with primary practice located at 175 Emery Highway , Macon GA 31217. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Johansen, Susan Bragdon can be contacted via phone (478) 751-4446.Contact Information
Primary practice address
175 Emery Highway
Macon GA 31217
Phone: (478) 751-4446
Fax: (478) 751-4444
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 003160 | Georgia |
Profile Details
| NPI number | 1114014446 |
|---|---|
| LBN Legal business name | Johansen, Susan Bragdon |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 6th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114014446 | NPPES |
| Georgia | Other | 003160 | LPC |
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