Provider Demographics
NPI:1679025134
Name:JOHNSON-HANEY, PATRICIA J (CSAC, LCSW)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:J
Last Name:JOHNSON-HANEY
Suffix:
Gender:F
Credentials:CSAC, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:971 RIVERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54303-6436
Mailing Address - Country:US
Mailing Address - Phone:920-680-6662
Mailing Address - Fax:920-337-6741
Practice Address - Street 1:971 RIVERVIEW DR
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54303-6436
Practice Address - Country:US
Practice Address - Phone:920-680-6662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-01
Last Update Date:2025-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16370-132101YA0400X
WI10247-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)