Individual
WILLIE EDWARD JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW
Contact information
Practice address
7550 CONSTANTINOPLE AVE BLDG 2, LAS VEGAS, NV 89129-6505
(702) 421-5563
Mailing address
9360 WARM WATERS AVE, LAS VEGAS, NV 89129-7865
(702) 421-3741
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5530-C
NV
1041C0700X
Clinical Social Worker
6801062390
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9005051634
—
NV
Enumeration date
08/21/2008
Last updated
03/12/2009
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