Johnson, Timothy

Johnson, Timothy is an individual health care provider with primary practice located at 207 Perry Wiley Way , Chesterfield SC 29709. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Johnson, Timothy can be contacted via phone (843) 423-8292.

Contact Information

Primary practice address
207 Perry Wiley Way Chesterfield SC 29709
Phone: (843) 423-8292
Fax: (843) 423-8294
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1891393708
LBN Legal business name Johnson, Timothy
Credentials BACHELOR OF PSYCHOLO
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2020
Last updated Oct 26th, 2022 - about 3 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 1891393708 NPPES
South Carolina MEDICAID 405127
South Carolina MEDICAID 251S00000X

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