Healthcare Provider Details

I. General information

NPI: 1457084139
Provider Name (Legal Business Name): JOHNNY ARAGON LCSW-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2022
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 GARRISON BLVD STE 103
BALTIMORE MD
21216-2692
US

IV. Provider business mailing address

2200 GARRISON BLVD STE 103
BALTIMORE MD
21216-2692
US

V. Phone/Fax

Practice location:
  • Phone: 833-888-0805
  • Fax:
Mailing address:
  • Phone: 833-888-0805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number28461
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904018745
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: