Individual provider · Type 1 NPI

Ebony Shante Johnson

Mental Health Counselor · Bridgeport, CT

NPI number 1992450852 Active

Practice location

170 Bennett St
Bridgeport, CT 06605-2901

Call (203) 864-5013 Map

Mailing address

140 Texas Ave
Bridgeport, CT 06610-1852

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1992450852

Ebony Shante Johnson's National Provider Identifier is 1992450852, issued on Feb 18, 2022. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Bridgeport, CT. The record was last updated on Feb 18, 2022.