Provider Demographics
NPI:1306612999
Name:JOHNSON, MONICA SHAWN (LCSW)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:SHAWN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 SOUTH PADRE ISLAND DRIVE
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78416
Mailing Address - Country:US
Mailing Address - Phone:361-806-5600
Mailing Address - Fax:
Practice Address - Street 1:925 SOUTH PADRE ISLAND DRIVE
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78416
Practice Address - Country:US
Practice Address - Phone:361-806-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX538211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical