Provider Demographics
NPI:1881024925
Name:JOHNSON, HARRIET (LCSW)
Entity Type:Individual
Prefix:
First Name:HARRIET
Middle Name:
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 1:772 ESTERBROOK CT
Mailing Address - Street 2:APT A
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-3484
Mailing Address - Country:US
Mailing Address - Phone:510-307-1685
Mailing Address - Fax:510-307-1615
Practice Address - Street 1:772 ESTERBROOK CT
Practice Address - Street 2:APT A
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-3484
Practice Address - Country:US
Practice Address - Phone:510-307-1685
Practice Address - Fax:510-307-1615
Is Sole Proprietor?:No
Enumeration Date:2013-11-26
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010619741041C0700X
CALCS287731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical