Individual
JASON JESSE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BHP
Contact information
Practice address
1618 SHERWOOD AVE, BALTIMORE, MD 21239-2410
(410) 980-4761
Mailing address
1618 SHERWOOD AVE, BALTIMORE, MD 21239-2410
(410) 980-4761
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
MD
175T00000X
Peer Specialist
—
—
225C00000X
Rehabilitation Counselor
—
—
251E00000X
Home Health Agency
—
—
320700000X
Physical Disabilities Residential Treatment Facility
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
05/25/2019
Last updated
10/17/2021
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