Individual
JENNIFER JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
4400 OLD CANTON RD, JACKSON, MS 39211-5982
(601) 984-4465
(601) 815-0434
Mailing address
2500 N. STATE STREET, CBO - SUITE 4200, JACKSON, MS 39216-4500
(601) 496-9794
(601) 815-0434
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C8480
MS
Other
Enumeration date
08/20/2019
Last updated
08/20/2019
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