Johnson, Dalton James
Johnson, Dalton James is an sole proprietor health care provider with primary practice located at 4660 Prestancia Pl Apt 107 , Waldorf MD 20602-4119. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Johnson, Dalton James can be contacted via phone (301) 645-5460.Contact Information
Primary practice address
4660 Prestancia Pl Apt 107
Waldorf MD 20602-4119
Phone: (301) 645-5460
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | ||
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | LCO791 | Maryland |
Profile Details
| NPI number | 1861694051 |
|---|---|
| LBN Legal business name | Johnson, Dalton James |
| Credentials | L.C.P.C. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 1st, 2007 |
| Last updated | Dec 18th, 2018 - about 7 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 | 1861694051 | NPPES |
| Maryland | MEDICAID | 303902100 |
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