| Doctor Name: | MRS. MARY ELIZABETH BASS JOHNSON |
| NPI Number: | 1164573929 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCWCS |
| License Number: | 04362 |
| Business Practice Address: | 2429 Chetwood Circle Ste 2 Timonium, MD - 210932533 |
| Business Phone Number: | 4107443322 |
| Business Fax Number: | 4107443326 |
| Mailing Address: | 2429 Chetwood Circle, Ste 2 TIMONIUM |
| State: | MD |
| Postal Code: | 210932533 |
| Phone Number: | 4107443322 |
| Fax Number: | 4107443326 |
| NPI Enumeration Date: | 01/16/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 04362 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |