Healthcare Provider Details

I. General information

NPI: 1528097334
Provider Name (Legal Business Name): YVONNE JOHNSON-GILBERT LCSW,DCSW,ATODS,CCJS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 COWBOY WAY
CANTON NC
28716-9411
US

IV. Provider business mailing address

PO BOX 30
CANTON NC
28716-0030
US

V. Phone/Fax

Practice location:
  • Phone: 282-648-8052
  • Fax: 828-648-8052
Mailing address:
  • Phone: 828-648-8052
  • Fax: 828-648-8052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: