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General NPI Number Information
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NPI Number | 1730447384
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Entity Type | Organization
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Legal Business Name | T.JOHNSON & ASSOCIATES, LLC
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Dates
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Enumeration Date | 05/01/2012
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Last Update Date | 05/01/2012
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Provider Practice Location Address
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Address Line | 5200 LAPALCO BLVD SUITE #2
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City | MARRERO
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State | LA
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Zip | 70072-4254
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Country | US
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Telephone | 504-265-8115
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Fax |
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Provider Business Mailing Address
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Address Line | 5200 LAPALCO BLVD SUITE #2
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City | MARRERO
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State | LA
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Zip | 70072-4254
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Country | US
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Telephone | 504-265-8115
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Fax |
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Authorized Official
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Title or Position | PRIVATE PRATITIONER
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Name | MR. TRAVIS JOHNSON SR.
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Credential | LPC, LAC
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Telephone | 504-265-8115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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