Provider Demographics
NPI:1124368691
Name:JOHNSON, VENITTA RENEA (LCSW)
Entity type:Individual
Prefix:
First Name:VENITTA
Middle Name:RENEA
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:VENITTA
Other - Middle Name:R
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:224 GREAT BRIDGE BLVD
Mailing Address - Street 2:CHESAPEAKE COMMUNITY SERVICES BOARD
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-3904
Mailing Address - Country:US
Mailing Address - Phone:757-547-9334
Mailing Address - Fax:757-819-6292
Practice Address - Street 1:3388 PRINCESS ANNE RD STE 2001
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-2612
Practice Address - Country:US
Practice Address - Phone:757-507-7270
Practice Address - Fax:833-406-3955
Is Sole Proprietor?:No
Enumeration Date:2013-02-21
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040081351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical