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General NPI Number Information
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NPI Number | 1811484561
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Entity Type | Individual
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Provider Name | EARL JOHNSON JR. MPA
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Gender | Male
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Dates
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Enumeration Date | 04/18/2018
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Last Update Date | 10/26/2018
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Provider Practice Location Address
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Address Line | 16332 NATALIE LN
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City | PRAIRIEVILLE
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State | LA
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Zip | 70769-5378
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Country | US
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Telephone | 225-773-3999
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Fax | 225-410-3599
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Provider Business Mailing Address
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Address Line | 16332 NATALIE LN
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City | PRAIRIEVILLE
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State | LA
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Zip | 70769-5378
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Country | US
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Telephone | 225-773-3999
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Fax | 225-410-3599
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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 | 101Y00000X
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Taxonomy Name | Counselor
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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