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Individual

KEYA JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW, CCTP, CSOTP

Contact information

Practice address
1770 INDIAN TRAIL RD, SUITE 140, NORCROSS, GA 30093-2627
(404) 883-0724
(866) 282-7377
Mailing address
780 MOROSGO DR NE #14614, ATLANTA, GA 30324-9840
(404) 883-0724
(866) 282-7377

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
19722
MD
1041C0700X
Clinical Social Worker
Primary
CSW006294
GA

Other

Enumeration date
04/08/2014
Last updated
01/11/2019
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