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Individual

BENJAMIN ADAM JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
5015 S IH 35 STE 200, AUSTIN, TX 78744-2714
(512) 804-3236
Mailing address
1430 COLLIER ST, AUSTIN, TX 78704-2911
(512) 472-4357
(512) 703-1394

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
63264
TX

Other

Enumeration date
08/05/2018
Last updated
08/05/2018
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