Provider Demographics
NPI:1891946000
Name:JOHNSON, NORA J (PSYD)
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:J
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 LOMBARD ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1414
Mailing Address - Country:US
Mailing Address - Phone:215-893-6423
Mailing Address - Fax:215-893-6401
Practice Address - Street 1:1800 LOMBARD STREET, 3RD FLOOR
Practice Address - Street 2:DEPARTMENT OF PSYCHIATRY - RITTENHOUSE
Practice Address - City:PHILADEPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-1498
Practice Address - Country:US
Practice Address - Phone:215-893-6423
Practice Address - Fax:215-893-6401
Is Sole Proprietor?:No
Enumeration Date:2008-10-07
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS016508103T00000X, 103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
No103T00000XBehavioral Health & Social Service ProvidersPsychologist