Organization
MATTHEW R. JOHNSON III
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW R. JOHNSON III LCSW (OWNER)
(985) 643-2411
Entity
Organization
Contact information
Practice address
620 OAK HARBOR BLVD, 101, SLIDELL, LA 70458-8862
(985) 643-2411
Mailing address
620 OAK HARBOR BLVD, 101, SLIDELL, LA 70458-8862
(985) 643-2411
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5531
LA
Other
Enumeration date
10/14/2016
Last updated
10/14/2016
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