Provider Demographics
NPI:1568202406
Name:DANETTE DOLLISON-JOHNSON, LLC
Entity type:Organization
Organization Name:DANETTE DOLLISON-JOHNSON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOLLISON-JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S, MT-BC
Authorized Official - Phone:504-732-9730
Mailing Address - Street 1:203 SIERRA CT
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-5327
Mailing Address - Country:US
Mailing Address - Phone:504-732-9730
Mailing Address - Fax:844-803-5223
Practice Address - Street 1:203 SIERRA CT
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-5327
Practice Address - Country:US
Practice Address - Phone:504-732-9730
Practice Address - Fax:844-803-5223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty