Doctor Name: | COMATHA B JOHNSON |
NPI Number: | 1023287877 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.C.S.W. |
License Number: | 3153334 |
Business Practice Address: | 1705 N Berkeley Blvd Goldsboro, NC - 275343305 |
Business Phone Number: | 9197510277 |
Business Fax Number: | 9197510278 |
Mailing Address: | 1705 N Berkeley Blvd, GOLDSBORO |
State: | NC |
Postal Code: | 275343305 |
Phone Number: | 9197510277 |
Fax Number: | 9197510278 |
NPI Enumeration Date: | 02/26/2008 |
NPI Last Update Date: | 02/26/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 3153334 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |