Provider Demographics
NPI:1902608987
Name:JOHNSON, RAEGAN PAIGE (MSW)
Entity type:Individual
Prefix:
First Name:RAEGAN
Middle Name:PAIGE
Last Name:JOHNSON
Suffix:
Gender:
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3241 HIGHWAY 175
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:LA
Mailing Address - Zip Code:71065-5126
Mailing Address - Country:US
Mailing Address - Phone:318-315-3871
Mailing Address - Fax:
Practice Address - Street 1:1200 KEYSER AVE STE C
Practice Address - Street 2:
Practice Address - City:NATCHITOCHES
Practice Address - State:LA
Practice Address - Zip Code:71457-6264
Practice Address - Country:US
Practice Address - Phone:318-357-0018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator