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NPI Code Detail

MEDICARE: TAMARA NATALEE JOHNSON MSW

MEDICARE: TAMARA NATALEE JOHNSON MSW
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
1171M00000XCase Manager/Care Coordinator
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1871126789
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMARA NATALEE JOHNSON MSW
Provider Business Mailing Address
First Line : 5305 GREENWOOD AVE STE 204
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33407-2449
Country : US
Telephone Number : 561-557-6651
Fax Number : 561-557-6711
Provider Business Practice Location Address
First Line : 5305 GREENWOOD AVE STE 204
Second Line :
City : WEST PALM BEACH
State : FL
Zip : 33407-2449
Country : US
Telephone Number : 561-557-6651
Fax Number : 561-557-6711
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2020
Last Update Date : 10/11/2021

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