Healthcare Provider Details

I. General information

NPI: 1568793222
Provider Name (Legal Business Name): DONNASUE JOHNSON LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2010
Last Update Date: 11/14/2024
Certification Date: 11/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 NORTH ST
HARRISON NY
10528-1524
US

IV. Provider business mailing address

11 WHITE PLAINS AVE
ELMSFORD NY
10523-2724
US

V. Phone/Fax

Practice location:
  • Phone: 212-525-5235
  • Fax:
Mailing address:
  • Phone: 914-837-4915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number078477-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number086291
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: