Provider Demographics
NPI:1922463314
Name:JOHNSON, ASHLEY (LSW)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3379 US HIGHWAY 46 APT 8G
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-1242
Mailing Address - Country:US
Mailing Address - Phone:973-670-4257
Mailing Address - Fax:
Practice Address - Street 1:20 VANDERHOOF AVE
Practice Address - Street 2:
Practice Address - City:ROCKAWAY
Practice Address - State:NJ
Practice Address - Zip Code:07866-3148
Practice Address - Country:US
Practice Address - Phone:973-586-5243
Practice Address - Fax:973-627-2520
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-29
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management