Johnson, Juanita S.
Johnson, Juanita S. is an individual health care provider with primary practice located at 20 W Bank St Suite 5, Petersburg VA 23803-3279. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Johnson, Juanita S. can be contacted via phone (804) 863-1689.Contact Information
Primary practice address
20 W Bank St Suite 5
Petersburg VA 23803-3279
Phone: (804) 863-1689
Fax: (804) 863-1695
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 07010026 | Virginia |
Profile Details
| NPI number | 1639113574 |
|---|---|
| LBN Legal business name | Johnson, Juanita S. |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 15th, 2006 |
| Last updated | Jul 9th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639113574 | NPPES |
| Virginia | MEDICAID | 140491 | |
| Virginia | MEDICAID | 089366 | |
| Virginia | MEDICAID | 117957 | |
| Virginia | MEDICAID | 224111 |
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