Individual
DR. JOHNATHAN MATTHEW JOHNSON SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA, MSPC
Contact information
Practice address
1100 W 6TH AVE, GARY, IN 46402-1711
(219) 885-4264
Mailing address
15301 S. LEXINGTON AVE., HARVEY, IL 60426-1711
(708) 439-1832
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
10/22/2015
Last updated
08/04/2024
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