Provider Demographics
NPI:1528707650
Name:JOHNSON, CATHERINE AMANDA (MS, MA)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:AMANDA
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MS, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1133 WESTCHESTER AVE STE N-006
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10604-3550
Mailing Address - Country:US
Mailing Address - Phone:914-539-7600
Mailing Address - Fax:
Practice Address - Street 1:84 ANTIETAM STREET
Practice Address - Street 2:2ND FLOOR
Practice Address - City:DEVENS
Practice Address - State:MA
Practice Address - Zip Code:01434
Practice Address - Country:US
Practice Address - Phone:978-451-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-27
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health