Provider Demographics
NPI:1821361841
Name:JOHNSON, LAMARA LEE (LCSW)
Entity Type:Individual
Prefix:
First Name:LAMARA
Middle Name:LEE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 W TUNNEL BLVD
Mailing Address - Street 2:STE. 430
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-2801
Mailing Address - Country:US
Mailing Address - Phone:985-853-8550
Mailing Address - Fax:
Practice Address - Street 1:8326 MAIN ST BLDG 3
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70363-4871
Practice Address - Country:US
Practice Address - Phone:985-868-2620
Practice Address - Fax:985-868-8547
Is Sole Proprietor?:No
Enumeration Date:2012-02-22
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA118961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical