Individual
CHRISTOPHER WAYNE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW/CASAC
Contact information
Practice address
4904 19TH AVE, ASTORIA, NY 11105-1002
(347) 774-7864
Mailing address
302 ASTORIA BLVD, APT 6B, ASTORIA, NY 11102-4703
(347) 401-1000
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
21630
NY
104100000X
Social Worker
Primary
094128
NY
Other
Enumeration date
03/10/2015
Last updated
03/10/2015
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