Provider Demographics
NPI:1528218054
Name:JOHNSON, CHRISTOPHER
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 325
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27402-0325
Mailing Address - Country:US
Mailing Address - Phone:336-772-6946
Mailing Address - Fax:866-775-0584
Practice Address - Street 1:1400 BATTLEGROUND AVE
Practice Address - Street 2:SUITE 134 A
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-8042
Practice Address - Country:US
Practice Address - Phone:336-772-6946
Practice Address - Fax:866-775-0584
Is Sole Proprietor?:No
Enumeration Date:2008-09-20
Last Update Date:2008-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker