Provider Demographics
NPI:1407507858
Name:JOHNSON, SYLVANNA F (MSW)
Entity Type:Individual
Prefix:
First Name:SYLVANNA
Middle Name:F
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9235 DEWBERRY BLOSSOM LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064-4611
Mailing Address - Country:US
Mailing Address - Phone:504-638-5862
Mailing Address - Fax:
Practice Address - Street 1:9235 DEWBERRY BLOSSOM LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77064-4611
Practice Address - Country:US
Practice Address - Phone:504-638-5862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-17
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No251B00000XAgenciesCase Management