Provider Demographics
NPI:1033526702
Name:JOHNSON, DANIEL A (LCSW-C)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:A
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1522 CHESTER TOWN CIR
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21409-4295
Mailing Address - Country:US
Mailing Address - Phone:410-757-9549
Mailing Address - Fax:
Practice Address - Street 1:108 OLD SOLOMONS ISLAND RD
Practice Address - Street 2:UNIT 7
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3845
Practice Address - Country:US
Practice Address - Phone:410-266-8345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-15
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD155911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical