Provider Demographics
NPI:1598863672
Name:JOHNSON, ELIZABETH REEDER (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:REEDER
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5847 ELDERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-3451
Mailing Address - Country:US
Mailing Address - Phone:214-293-5618
Mailing Address - Fax:
Practice Address - Street 1:5600 W LOVERS LN
Practice Address - Street 2:SUITE 313-C
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75209-4330
Practice Address - Country:US
Practice Address - Phone:214-966-2786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLCSW #385891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical