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NPI Code Detail

MEDICARE: MRS. DESHANDA L JOHNSON LCSW-C

MEDICARE: MRS. DESHANDA L JOHNSON LCSW-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker12551MD

General Provider Information

NPI Number : 1144341207
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DESHANDA L JOHNSON LCSW-C
Provider Business Mailing Address
First Line : 800 INGLESIDE AVE
Second Line :
City : CATONSVILLE
State : MD
Zip : 21228-1722
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 800 INGLESIDE AVE
Second Line :
City : CATONSVILLE
State : MD
Zip : 21228-1722
Country : US
Telephone Number : 443-392-1327
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2007
Last Update Date : 03/21/2016

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