Most Relevant Information
Provider Data
| NPI Number: | 1003671553 |
| Provider Name: | STEPHEN MARK JOHNSON LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 34010944A |
Most Important Dates
| Enumeration Date: | 02/14/2024 |
| Last Updated: | 02/14/2024 |
Provider Practice Location
1481 W 10TH ST
INDIANAPOLIS
IN
462022803
Practice Location Phone/Fax
| Phone: | 8124781803 |
| Fax: |
Provider Mailing Location
1481 W 10TH ST
INDIANAPOLIS
IN
462022803
Provider Mailing Phone/Fax
| Phone: | 8124781803 |
| Fax: |