Provider Demographics
NPI:1790023489
Name:JOHNSON, INGA LOU (MSW/LMSW)
Entity Type:Individual
Prefix:MRS
First Name:INGA
Middle Name:LOU
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MSW/LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15644 SKANEE ROAD
Mailing Address - Street 2:
Mailing Address - City:L'ANSE
Mailing Address - State:MI
Mailing Address - Zip Code:49946
Mailing Address - Country:US
Mailing Address - Phone:906-524-5885
Mailing Address - Fax:906-524-5866
Practice Address - Street 1:15644 SKANEE RD
Practice Address - Street 2:
Practice Address - City:L'ANSE
Practice Address - State:MI
Practice Address - Zip Code:49946-9003
Practice Address - Country:US
Practice Address - Phone:906-524-5885
Practice Address - Fax:906-524-5866
Is Sole Proprietor?:No
Enumeration Date:2013-01-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical