Provider Demographics
NPI:1538996061
Name:JOHNSON, SHERRY MARIA (CSAC-S, QMHP)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:MARIA
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:CSAC-S, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2856 FOREHAND DR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-2006
Mailing Address - Country:US
Mailing Address - Phone:757-861-9020
Mailing Address - Fax:757-861-9021
Practice Address - Street 1:2856 FOREHAND DR
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23323-2006
Practice Address - Country:US
Practice Address - Phone:757-861-9020
Practice Address - Fax:757-861-9021
Is Sole Proprietor?:No
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)