MEDICARE: VICTORIA T JOHNSON

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
1	1041C0700X	Clinical Social Worker	44SC06315400	NJ

General Provider Information

NPI Number	:	1750955498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA T JOHNSON

Provider Business Mailing Address
First Line	:	PO BOX 233
Second Line	:
City	:	ABSECON
State	:	NJ
Zip	:	08201-0233
Country	:	US
Telephone Number	:	609-517-3159
Fax Number	:

Provider Business Practice Location Address
First Line	:	536 MAPLE AVE
Second Line	:
City	:	LINWOOD
State	:	NJ
Zip	:	08221-1213
Country	:	US
Telephone Number	:	609-415-4901
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2021
Last Update Date	:	05/29/2024

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Directions to “ VICTORIA T JOHNSON ” Practice Location

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