Provider Demographics
NPI:1922373851
Name:JOHNSON, JEFFREY A (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:A
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 ROE LN
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07731-9071
Mailing Address - Country:US
Mailing Address - Phone:908-433-7388
Mailing Address - Fax:
Practice Address - Street 1:28 ROE LN
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-9071
Practice Address - Country:US
Practice Address - Phone:908-433-7388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-10
Last Update Date:2012-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SCOOO852001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical