Healthcare Provider Details

I. General information

NPI: 1184561383
Provider Name (Legal Business Name): EJ JOHNSON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ALABAMA A&M UNIVERSITY 104 BUCHANAN HALL
NORMAL AL
35762
US

IV. Provider business mailing address

ALABAMA A&M UNIVERSITY 104 BUCHANAN HALL
NORMAL AL
35762
US

V. Phone/Fax

Practice location:
  • Phone: 256-372-5475
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: