Provider Demographics
NPI:1811907892
Name:JOHNSON-DAY, JOHNNIE BRENAY (MSW,LCSW)
Entity type:Individual
Prefix:MS
First Name:JOHNNIE
Middle Name:BRENAY
Last Name:JOHNSON-DAY
Suffix:
Gender:F
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 1:10517 CHICKERING DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-5711
Mailing Address - Country:US
Mailing Address - Phone:314-869-0794
Mailing Address - Fax:314-521-2786
Practice Address - Street 1:9167 W FLORISSANT AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-1420
Practice Address - Country:US
Practice Address - Phone:314-521-7900
Practice Address - Fax:314-521-2786
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0026421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical