Healthcare Provider Details

I. General information

NPI: 1801727227
Provider Name (Legal Business Name): DELANE JOHNSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9401 CORKSCREW PALMS CIR STE 300
ESTERO FL
33928-6628
US

IV. Provider business mailing address

9401 CORKSCREW PALMS CIR STE 300
ESTERO FL
33928-6628
US

V. Phone/Fax

Practice location:
  • Phone: 239-676-0601
  • Fax: 239-676-0608
Mailing address:
  • Phone: 239-676-0601
  • Fax: 239-676-0608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW26558
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: