Provider Demographics
NPI:1275060048
Name:JOHNSON, JA'NERA
Entity Type:Individual
Prefix:
First Name:JA'NERA
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 METAIRIE RD # 8317
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-4034
Mailing Address - Country:US
Mailing Address - Phone:504-329-6986
Mailing Address - Fax:
Practice Address - Street 1:609 METAIRIE RD # 8317
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-4034
Practice Address - Country:US
Practice Address - Phone:504-329-6986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1082781041C0700X
LA137581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical