Provider Demographics
NPI:1811573421
Name:JOHNSON, PARIS LESLIE (MSW)
Entity Type:Individual
Prefix:MS
First Name:PARIS
Middle Name:LESLIE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 CHAPMAN RD STE 201
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5415
Mailing Address - Country:US
Mailing Address - Phone:302-292-2334
Mailing Address - Fax:
Practice Address - Street 1:256 CHAPMAN RD STE 201
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5415
Practice Address - Country:US
Practice Address - Phone:302-292-2334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health