Individual
JESSE J JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PEER SUPPORT SPECIAL
Contact information
Practice address
1003 PARK ST, OGDENSBURG, NY 13669-3911
(518) 713-9090
(315) 713-9330
Mailing address
324 COUNTY ROUTE 51 BLDG 1, MALONE, NY 12953-4502
(518) 651-2302
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/09/2025
Last updated
07/09/2025
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