Johnson, Bruce David

Johnson, Bruce David is an individual health care provider with primary practice located at 230 East Marydale Suite 2, Soldotna AK 99669-7648. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Johnson, Bruce David can be contacted via phone (907) 260-3691.

Contact Information

Primary practice address
230 East Marydale Suite 2 Soldotna AK 99669-7648
Phone: (907) 260-3691
Fax: (907) 260-7301
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X

Profile Details

NPI number 1932398393
LBN Legal business name Johnson, Bruce David
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 22nd, 2007
Last updated May 16th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932398393 NPPES
Alaska MEDICAID FH177FQ
Alaska MEDICAID MH0150
Alaska MEDICAID MH0156

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