Individual
MRS. ANDRA D. JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW, LCSW, LCAC
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
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