Provider Demographics
NPI:1508924333
Name:JOHNSON, MONICA R (MA)
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:R
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MISS
Other - First Name:MONICA
Other - Middle Name:R
Other - Last Name:HENDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:15 SATUCKET TRL
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02324-1942
Mailing Address - Country:US
Mailing Address - Phone:508-697-0542
Mailing Address - Fax:
Practice Address - Street 1:288 BEDFORD ST
Practice Address - Street 2:
Practice Address - City:WHITMAN
Practice Address - State:MA
Practice Address - Zip Code:02382-1820
Practice Address - Country:US
Practice Address - Phone:781-447-6425
Practice Address - Fax:781-447-1786
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health