Healthcare Provider Details

I. General information

NPI: 1174046296
Provider Name (Legal Business Name): REGINA JONES-JOHNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2017
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3084 WESTFORK DR STE C
BATON ROUGE LA
70816-2254
US

IV. Provider business mailing address

2060 HEMLOCK ST
BATON ROUGE LA
70802-3456
US

V. Phone/Fax

Practice location:
  • Phone: 225-296-6083
  • Fax:
Mailing address:
  • Phone: 225-955-7567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number11623
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: