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Individual

MS. TINA JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
2008 OAK GROVE RD APT 10, HATTIESBURG, MS 39402-1416
(832) 740-9198
Mailing address
2008 OAK GROVE RD APT 10, HATTIESBURG, MS 39402-1416
(832) 740-9198

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C8883
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
M8883
MISSISSIPPI BOARD OF EXAMINERS FOR SOCIAL WORKERS
MS
Enumeration date
01/08/2019
Last updated
10/29/2021
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