Provider Demographics
NPI:1558001222
Name:JOHNSON, MARIA ANNTOINETTE (LICSW, LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ANNTOINETTE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LICSW, LCSW-C
Other - Prefix:MRS
Other - First Name:MARIA
Other - Middle Name:ANNTOINETTE
Other - Last Name:MILLER JOHNSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSW, LCSW-C
Mailing Address - Street 1:9420 ANNAPOLIS RD STE 300
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3065
Mailing Address - Country:US
Mailing Address - Phone:202-746-0742
Mailing Address - Fax:
Practice Address - Street 1:9420 ANNAPOLIS RD STE 300
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3065
Practice Address - Country:US
Practice Address - Phone:202-746-0742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-31
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD108011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical