Johnson, Bruce David
Johnson, Bruce David is an individual health care provider with primary practice located at 230 East Marydale Suite 2, Soldotna AK 99669-7648. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Johnson, Bruce David can be contacted via phone (907) 260-3691.Contact Information
Primary practice address
230 East Marydale Suite 2
Soldotna AK 99669-7648
Phone: (907) 260-3691
Fax: (907) 260-7301
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Clinical | 1041C0700X |
Profile Details
NPI number | 1932398393 |
---|---|
LBN Legal business name | Johnson, Bruce David |
Credentials | Licensed Clinical Social Worker (LCSW) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Oct 22nd, 2007 |
Last updated | May 16th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1932398393 | NPPES |
Alaska | MEDICAID | FH177FQ | |
Alaska | MEDICAID | MH0150 | |
Alaska | MEDICAID | MH0156 |
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