Provider Demographics
NPI:1720181944
Name:JOHNS, SALLY HUGGINS (LCSW)
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:HUGGINS
Last Name:JOHNS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:SALLY
Other - Middle Name:JANE
Other - Last Name:HUGGINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:114 RHETT CT
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921
Mailing Address - Country:US
Mailing Address - Phone:410-392-9584
Mailing Address - Fax:410-392-6620
Practice Address - Street 1:1601 MILLTOWN RD
Practice Address - Street 2:STE 8
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-4027
Practice Address - Country:US
Practice Address - Phone:302-547-7710
Practice Address - Fax:410-392-6620
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ100001051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
0004412825OtherAETNA
0418724000OtherINDEPENDENCE BCBS
1107826OtherCONNECTICUT GENERAL
0001002941OtherMHN
1664421OtherAMERI HEALTH
2257788OtherAETNA
6214160OtherUHC
A751384OtherVALUE OPTIONS