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Organization

DOMINION PSYCHOLOGICAL ASSOCIATES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHELLE JAN JOHNSON LCSW (LCSW/ADMINISTRATOR)
(757) 550-5266
Entity
Organization

Contact information

Practice address
809 MAIN STREET, STE #101, NEWPORT NEWS, VA 23605
(757) 550-5266
Mailing address
1706 TODDS LN # 331, HAMPTON, VA 23666-3123
(757) 550-5266

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Enumeration date
03/04/2021
Last updated
03/04/2021
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