Doctor Name: | SAMUEL JOHNSON |
NPI Number: | 1487032751 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW |
License Number: | 1390 |
Business Practice Address: | 302 Railway Avenue Seward, AK - 99664 |
Business Phone Number: | 9072245257 |
Business Fax Number: | |
Mailing Address: | Po Box 1045, SEWARD |
State: | AK |
Postal Code: | 996641045 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/07/2015 |
NPI Last Update Date: | 05/07/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 1390 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |