Healthcare Provider Details

I. General information

NPI: 1891189916
Provider Name (Legal Business Name): ROBIN SIMMONS-JOHNSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2015
Last Update Date: 05/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5593 HIGHWAY 311
HOUMA LA
70360-2866
US

IV. Provider business mailing address

8326 MAIN ST BLDG 3
HOUMA LA
70363-4871
US

V. Phone/Fax

Practice location:
  • Phone: 985-868-2620
  • Fax: 985-868-8547
Mailing address:
  • Phone: 985-868-2620
  • Fax: 985-868-8547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number12820
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number12820
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: