Individual
MRS. LAKEISHA JOHNSON-ELMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5565 KINGS RETREAT DR E, HORN LAKE, MS 38637-7010
(662) 897-8940
Mailing address
5565 KINGS RETREAT DR E, HORN LAKE, MS 38637-7010
(662) 897-8940
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
7551-C
AR
1041C0700X
Clinical Social Worker
C8311
MS
1041C0700X
Clinical Social Worker
Primary
LSW0000007453
TN
Other
Enumeration date
12/03/2014
Last updated
05/20/2021
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