Provider Demographics
NPI:1306141577
Name:JOHNSON, LOVINE H (MSW, CSW)
Entity type:Individual
Prefix:MISS
First Name:LOVINE
Middle Name:H
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MSW, CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3988
Mailing Address - Street 2:
Mailing Address - City:KINGSHILL
Mailing Address - State:VI
Mailing Address - Zip Code:00851-3988
Mailing Address - Country:US
Mailing Address - Phone:340-513-0103
Mailing Address - Fax:
Practice Address - Street 1:THE VILLAGE MALL
Practice Address - Street 2:#113
Practice Address - City:KINGSHILL
Practice Address - State:VI
Practice Address - Zip Code:00850-4701
Practice Address - Country:US
Practice Address - Phone:340-778-5553
Practice Address - Fax:340-778-9497
Is Sole Proprietor?:No
Enumeration Date:2011-01-20
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VIC-100014533-20101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical