Johnson, Jake A

Johnson, Jake A is an sole proprietor health care provider with primary practice located at 14300 Gallant Fox Ln Suite 211, Bowie MD 20715-4003. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Johnson, Jake A can be contacted via phone (301) 262-2828.

Contact Information

Primary practice address
14300 Gallant Fox Ln Suite 211 Bowie MD 20715-4003
Phone: (301) 262-2828
Fax: (301) 262-7637
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 297 Maryland
Behavioral Health & Social Service Providers / Professional 101YP2500X 297 Maryland

Profile Details

NPI number 1164625240
LBN Legal business name Johnson, Jake A
Credentials DOCTORATE
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 7th, 2007
Last updated Jul 8th, 2007 - about 17 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.

Request for update

Popular Providers