Individual
SHANTAE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 LAFAYETTE ST, STE 150, GRETNA, LA 70053-5799
(504) 846-6983
(504) 838-5714
Mailing address
5928 THREE OAKS CT, MARRERO, LA 70072-5897
(504) 657-8018
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
Primary
14026
LA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
03/02/2016
Last updated
08/19/2020
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