Healthcare Provider Details

I. General information

NPI: 1639540776
Provider Name (Legal Business Name): ANA MARIA JOHNSON LICSW, LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2015
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14502 GREENVIEW DR STE 500
LAUREL MD
20708-4245
US

IV. Provider business mailing address

14502 GREENVIEW DR STE 500 #1169
LAUREL MD
20708-4245
US

V. Phone/Fax

Practice location:
  • Phone: 301-458-0201
  • Fax:
Mailing address:
  • Phone: 301-458-0201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number50081992
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number26781
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: