Individual
JAMIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
600 MEDICAL DR, STE A & B, HAMPTON, VA 23666-1769
(757) 788-0300
(757) 788-0969
Mailing address
300 MEDICAL DR, HAMPTON, VA 23666-1765
(757) 788-0300
(757) 788-0969
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904008538
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659424448
—
VA
Enumeration date
08/06/2014
Last updated
03/19/2017
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