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General NPI Number Information
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NPI Number | 1114175841
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Entity Type | Individual
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Provider Name | SHONTINA JOHNSON FLOYD LCSW, CFSW, C-ASWCM
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Gender | Female
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Dates
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Enumeration Date | 09/06/2008
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Last Update Date | 08/26/2018
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Provider Practice Location Address
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Address Line | 1287 MARKS CHURCH RD STE 1
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City | AUGUSTA
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State | GA
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Zip | 30909
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Country | US
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Telephone | 706-373-0579
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Fax | 844-385-8096
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Provider Business Mailing Address
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Address Line | 1287 MARKS CHURCH RD STE 1
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City | AUGUSTA
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State | GA
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Zip | 30909-6330
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Country | US
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Telephone | 706-373-0579
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Fax | 844-385-8096
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW11594
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW005198
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License Number State | GA
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