Individual
MS. SANDY J JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
55 NESCONSET HWY, PORT JEFFERSON STATION, NY 11776-2631
(631) 871-8454
(631) 689-3774
Mailing address
3 SILVER BEECH CT, SETAUKET, NY 11733-4039
(631) 689-3808
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
000029
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1072830
AFFINITY HEALTH PLAN
NY
01
—
11563006
OXFORD INS. PROVIDER ID
NY
Enumeration date
12/23/2006
Last updated
06/03/2008
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