Provider Demographics
NPI:1235921529
Name:JOHNSON, GEORGETTE ANNETTE (SOCIAL WORKER)
Entity type:Individual
Prefix:
First Name:GEORGETTE
Middle Name:ANNETTE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1876 E SABIN DR STE 15A
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-6198
Mailing Address - Country:US
Mailing Address - Phone:520-836-2536
Mailing Address - Fax:520-783-4368
Practice Address - Street 1:1876 E SABIN DR STE 15A
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-6198
Practice Address - Country:US
Practice Address - Phone:520-836-2536
Practice Address - Fax:520-783-4368
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker