Provider Demographics
NPI:1639851793
Name:JOHNSON, HALI L (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:HALI
Middle Name:L
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:HALI
Other - Middle Name:L
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4325 BUENA VISTA RD
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93311-8701
Mailing Address - Country:US
Mailing Address - Phone:661-858-8519
Mailing Address - Fax:661-410-1110
Practice Address - Street 1:4325 BUENA VISTA RD
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-8701
Practice Address - Country:US
Practice Address - Phone:661-858-8519
Practice Address - Fax:661-410-1110
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1148681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical