Johnson, Tita

Johnson, Tita is an individual health care provider with primary practice located at 709 Mill St , Camden SC 29020-4738. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Johnson, Tita can be contacted via phone (803) 432-6902.

Contact Information

Primary practice address
709 Mill St Camden SC 29020-4738
Phone: (803) 432-6902
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 1208155 South Carolina
Behavioral Health & Social Service Providers / Professional 101YP2500X 5525 South Carolina

Profile Details

NPI number 1144563941
LBN Legal business name Johnson, Tita
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2013
Last updated May 27th, 2013 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144563941 NPPES
South Carolina MEDICAID AD22KE

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