Provider Demographics
NPI:1962671271
Name:JOHNSON, SONYA YVETTE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SONYA
Middle Name:YVETTE
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 1:2200 MARKET ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77550-1530
Mailing Address - Country:US
Mailing Address - Phone:409-762-8636
Mailing Address - Fax:409-762-4185
Practice Address - Street 1:1501 N AMBURN RD
Practice Address - Street 2:SUITE 13
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77591-2484
Practice Address - Country:US
Practice Address - Phone:409-938-4814
Practice Address - Fax:409-938-4849
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX349541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical