Individual
AVEDA JANE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4404 QUEENS BLVD, SUNNYSIDE, NY 11104-2406
(239) 913-9360
Mailing address
2427 STEINWAY ST APT 3, ASTORIA, NY 11103-3618
(239) 913-9360
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
116761
NY
1041C0700X
Clinical Social Worker
Primary
101323
NY
Other
Enumeration date
07/25/2023
Last updated
04/07/2026
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