Andra D. Johnson in Fort Wayne - Addiction (substance Use Disorder)
Andra D. Johnson - NPI 1093787426
Andra D. Johnson is a Addiction (substance Use Disorder) in Fort Wayne, Indiana. Andra D. Johnson practices all healthcare services and medical treatments related to Addiction (substance Use Disorder). The NPI Number for Andra D. Johnson is 1093787426. The last update date is 2011-10-17.
Andra D. Johnson's current location address is 4656 W Jefferson Blvd, Fort Wayne, Indiana. You can contact this provider via phone number 2604229372 and fax number 2606720859. The mailing address for Andra D. Johnson is 4656 W Jefferson Blvd, Fort Wayne, Indiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Andra D. Johnson |
|---|---|
| Address | 4656 W Jefferson Blvd, Fort Wayne, Indiana |
| Phone Number | 2604229372 |
| Fax Number | 2606720859 |
| Sole Proprietor | Y |
| Credentials | LISW, LCSW |
NPI Number Detail
| NPI Number | 1093787426 |
|---|---|
| Provider Enumeration Date | 2006-02-01 |
| Last Updated Date | 2011-10-17 |
Provider Mailing Address Detail
| Address | 4656 W Jefferson Blvd |
|---|---|
| City | Fort Wayne |
| State | Indiana (IN) |
| Post Code | 468046857 |
| Phone Number | 2604229372 |
| Fax Number | 2606720859 |
Provider's Primary Taxonomy Detail
| Speciality | Addiction (substance Use Disorder) |
|---|---|
| Taxonomy | 101Ya0400X |
| Licence No | 991842 (LICD |
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Definition: A counselor who helps people with alcohol, drug, gambling, internet, and other types of addictions. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 39628200 -31/07 | WI | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Andra D. Johnson by the Centers for Medicare & Medicaid Services?
The Andra D. Johnson has been assigned the NPI (National Provider Identifier) 1093787426 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you kindly provide the complete physical address where Andra D. Johnson's facilities are geographically located?
The facilities of Andra D. Johnson are physically situated at the following location: 4656 W Jefferson Blvd, Fort Wayne, IN, 468046857.
What is Andra D. Johnson's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Andra D. Johnson is Addiction (substance Use Disorder), and the corresponding taxonomy classification code for this specialized field is 101Ya0400X.
On what date was the 1093787426 assigned to Andra D. Johnson?
The Andra D. Johnson was issued its 1093787426 on 2006-02-01, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
When was the information pertaining to Andra D. Johnson most recently updated or revised?
The details related to Andra D. Johnson, including its address, specialty, and other relevant information, were last updated or revised on 2011-10-17.