Provider Demographics
NPI:1275772402
Name:JOHNSON, LATONIA K (LCSW)
Entity Type:Individual
Prefix:
First Name:LATONIA
Middle Name:K
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LATONIA
Other - Middle Name:K
Other - Last Name:DUBOSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3100 DREWSKY LN UNIT 108
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29715-0112
Mailing Address - Country:US
Mailing Address - Phone:404-840-6462
Mailing Address - Fax:
Practice Address - Street 1:3100 DREWSKY LN UNIT 108
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29715-0112
Practice Address - Country:US
Practice Address - Phone:404-840-6462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-11
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical