Provider Demographics
NPI:1326250986
Name:JOHNSON, DEBORAH J (MSSA, LISW-S)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:J
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MSSA, LISW-S
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:J
Other - Last Name:JOHNSON, LISW-S, LLC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LISW-S
Mailing Address - Street 1:19710 UPPER TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-2231
Mailing Address - Country:US
Mailing Address - Phone:216-912-8748
Mailing Address - Fax:
Practice Address - Street 1:26250 EUCLID AVE STE 527
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44132
Practice Address - Country:US
Practice Address - Phone:440-233-7232
Practice Address - Fax:440-233-9070
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI0007826101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health