| V.k. Johnson, Lcsw & Consultants, Llc | |
|
2637 Ridgewood Rd Ste De Jackson MS 39216-4922 | |
| (601) 260-3065 | |
| Not Available |
| Full Name | V.k. Johnson, Lcsw & Consultants, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2637 Ridgewood Rd Ste De, Jackson, Mississippi |
| Authorized Official Name and Position | Venessia Johnson (OWNER) |
| Authorized Official Contact | 6012603065 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| V.k. Johnson, Lcsw & Consultants, Llc 194 Midway Estates Dr Terry MS 39170-8488 Ph: () - | V.k. Johnson, Lcsw & Consultants, Llc 2637 Ridgewood Rd Ste De Jackson MS 39216-4922 Ph: (601) 260-3065 |
| NPI Number | 1326502535 |
|---|---|
| Provider Enumeration Date | 01/22/2019 |
| Last Update Date | 02/05/2019 |
| Medicare PECOS PAC ID | 5294075925 |
|---|---|
| Medicare Enrollment ID | O20190315002461 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326502535 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| Provider Name | Venessia Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437640463 PECOS PAC ID: 6103166830 Enrollment ID: I20190315002478 |
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