Individual
CASEY ERIC JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
107 W PARK DR, HATTIESBURG, MS 39402-1363
(601) 909-6114
Mailing address
107 W PARK DR, HATTIESBURG, MS 39402-1363
(601) 577-1463
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C9324
MS
Other
Enumeration date
04/16/2022
Last updated
04/16/2022
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