Provider Demographics
NPI:1437621026
Name:DALTON J. JOHNSON & ASSOICATES
Entity Type:Organization
Organization Name:DALTON J. JOHNSON & ASSOICATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DALTON
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:301-645-5460
Mailing Address - Street 1:4660 PRESTANCIA PL APT 107
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-4119
Mailing Address - Country:US
Mailing Address - Phone:301-645-5460
Mailing Address - Fax:
Practice Address - Street 1:4660 PRESTANCIA PL APT 107
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-4119
Practice Address - Country:US
Practice Address - Phone:301-645-5460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-20
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health