Provider Demographics
NPI:1417975699
Name:JOHNSON, ARMA JEAN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ARMA
Middle Name:JEAN
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 1:6111 HARRISON ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-2969
Mailing Address - Country:US
Mailing Address - Phone:219-980-1973
Mailing Address - Fax:219-980-1369
Practice Address - Street 1:6111 HARRISON ST
Practice Address - Street 2:SUITE 310
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-2969
Practice Address - Country:US
Practice Address - Phone:219-980-1973
Practice Address - Fax:219-980-1369
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34001993A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN166000OtherPROVIDER ID
IN271334136OtherTAX IDENIFICATION NUMBER
IN0007989170OtherPROVIDER ID
IN000000283066OtherPROVIDER ID
IN216820AMedicare ID - Type UnspecifiedPROVIDER ID