Provider Demographics
NPI:1104186824
Name:JOHNSON, JOYCE (LCSW)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:
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 1:2003 LINCOLN DR W STE C
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-1529
Mailing Address - Country:US
Mailing Address - Phone:856-596-8007
Mailing Address - Fax:856-596-8699
Practice Address - Street 1:566 HADDON AVE
Practice Address - Street 2:
Practice Address - City:COLLINGSWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08108-1444
Practice Address - Country:US
Practice Address - Phone:856-858-9314
Practice Address - Fax:856-858-5672
Is Sole Proprietor?:No
Enumeration Date:2012-05-29
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC01487000101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health