Provider Demographics
NPI:1356554117
Name:JOHNSON, HOWARD NEWMAN (PHD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:NEWMAN
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 4TH PL SW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20024-2720
Mailing Address - Country:US
Mailing Address - Phone:202-488-3916
Mailing Address - Fax:202-488-3917
Practice Address - Street 1:614 4TH PL SW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20024-2720
Practice Address - Country:US
Practice Address - Phone:202-488-3916
Practice Address - Fax:202-488-3917
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDC761103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC03443029-00Medicaid