Provider Demographics
NPI:1386767309
Name:JOHNSON-AKRIDGE, GINGER PATRICIA (CASAC)
Entity type:Individual
Prefix:MRS
First Name:GINGER
Middle Name:PATRICIA
Last Name:JOHNSON-AKRIDGE
Suffix:
Gender:F
Credentials:CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 HERKIMER ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-1050
Mailing Address - Country:US
Mailing Address - Phone:917-207-8067
Mailing Address - Fax:
Practice Address - Street 1:91-01 MERRICK BLVD.
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432
Practice Address - Country:US
Practice Address - Phone:718-523-0146
Practice Address - Fax:718-523-5520
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10782101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)