Individual
MS. BEVERLY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-C
Contact information
Practice address
7178 COLUMBIA GATEWAY DR, COLUMBIA, MD 21046-2581
(410) 313-6202
Mailing address
7178 COLUMBIA GATEWAY DR, COLUMBIA, MD 21046-2581
(410) 313-6202
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCA111
MD
1041C0700X
Clinical Social Worker
Primary
11488
MD
Other
Enumeration date
06/09/2009
Last updated
06/09/2009
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