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Individual

LEONARD JOHNSON JR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
QMHSBA CMSBA

Contact information

Practice address
195 N GRANT AVE STE 250, COLUMBUS, OH 43215-2855
(440) 234-2006
Mailing address
434 EASTLAND RD, BEREA, OH 44017-1217
(440) 234-2006

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
OH
251S00000X
Community/Behavioral Health Agency
Primary
OH

Other

Enumeration date
06/04/2019
Last updated
06/04/2019
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