Provider Demographics
NPI:1053824383
Name:JOHNSON, ASIA (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:ASIA
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:ASIA
Other - Middle Name:
Other - Last Name:CRAFT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:HARRIS
Mailing Address - Street 1:301 PERKINS DR STE B
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005-3248
Mailing Address - Country:US
Mailing Address - Phone:575-652-3155
Mailing Address - Fax:505-441-2871
Practice Address - Street 1:1675 HICKORY LOOP
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-6587
Practice Address - Country:US
Practice Address - Phone:575-652-3155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-08
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAC-073106E00000X
106S00000X, 171M00000X
LA1-23-63492103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No171M00000XOther Service ProvidersCase Manager/Care Coordinator