1629369145 NPI number — SHERYL JOHNSON LCSW

Table of content: SHERYL JOHNSON LCSW (NPI 1629369145)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629369145 NPI number — SHERYL JOHNSON LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JOHNSON
Provider First Name:
SHERYL
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629369145
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/25/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1084 GRAHAMS WOOD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEWVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17241-9780
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
443-736-9047
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1779 W TRINDLE RD # 200-K
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARLISLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17015-9766
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-601-2824
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/02/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  16083 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: Q1-0001187 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: CW018693 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)