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General NPI Number Information
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NPI Number | 1790677565
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Entity Type | Individual
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Provider Name | ANISA JOHNSON LCSW-C
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Gender | Female
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Dates
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Enumeration Date | 07/16/2025
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 8990 OLD ANNAPOLIS RD
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City | COLUMBIA
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State | MD
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Zip | 21045-2182
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Country | US
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Telephone | 301-221-9094
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Fax |
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Provider Business Mailing Address
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Address Line | 224 SWEET PINE DR
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City | LAUREL
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State | MD
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Zip | 20724-2258
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Country | US
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Telephone |
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Fax |
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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 | 22519
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License Number State | MD
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