Individual
MRS. ANDRA D. JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW, LCSW, LCAC
Contact information
Practice address
4656 W JEFFERSON BLVD, SUITE 285, FORT WAYNE, IN 46804-6857
(260) 422-9372
(260) 672-0859
Mailing address
11014 CONSTANTIA CV, ROANOKE, IN 46783-8910
(216) 798-1997
(260) 672-0859
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
87000438A (LCAC)
IN
101YA0400X
Addiction (Substance Use Disorder) Counselor
991842 (LICDC)
OH
1041C0700X
Clinical Social Worker
2979-123 (LCSW)
WI
1041C0700X
Clinical Social Worker
Primary
34005636A (LCSW)
IN
1041C0700X
Clinical Social Worker
I - 0009358 (LISW)
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39628200 -31/078
—
WI
Enumeration date
02/01/2006
Last updated
10/17/2011
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us