Provider Demographics
NPI:1023196177
Name:JOHNSON, DEBRA ANN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:ANN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7614 NW TAYLOR AVE
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-2431
Mailing Address - Country:US
Mailing Address - Phone:580-647-9964
Mailing Address - Fax:
Practice Address - Street 1:DEPT. OF THE ARMY: USAMEDDAC
Practice Address - Street 2:ATTN: MCUA-CMH ATTN DEBRA JOHNSON
Practice Address - City:FT SILL
Practice Address - State:OK
Practice Address - Zip Code:73503-6300
Practice Address - Country:US
Practice Address - Phone:580-442-4351
Practice Address - Fax:580-442-7400
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK22671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical