| Donna Johanson Lcsw Llc | |
|
40 Spring Lake Rd Sherman CT 06784-1200 | |
| (860) 729-4631 | |
| (888) 972-5017 |
| Full Name | Donna Johanson Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 40 Spring Lake Rd, Sherman, Connecticut |
| Authorized Official Name and Position | Donna Johanson (PROVIDER) |
| Authorized Official Contact | 8607294631 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Donna Johanson Lcsw Llc 40 Spring Lake Rd Sherman CT 06784-1200 Ph: (860) 729-4631 | Donna Johanson Lcsw Llc 40 Spring Lake Rd Sherman CT 06784-1200 Ph: (860) 729-4631 |
| NPI Number | 1922491463 |
|---|---|
| Provider Enumeration Date | 03/09/2015 |
| Last Update Date | 03/09/2015 |
| Medicare PECOS PAC ID | 1658692066 |
|---|---|
| Medicare Enrollment ID | O20150610000403 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922491463 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 008353 (Connecticut) | Primary |
| Provider Name | Donna Johanson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093117145 PECOS PAC ID: 7810218229 Enrollment ID: I20150610000589 |
Mendelsohn Medical Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 18 Pinewood Shrs, Sherman, CT 06784 Phone: 203-794-6670 Fax: 888-974-3861 |