Provider Demographics
NPI:1356707962
Name:JOHNS, JESSICA (LMSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:JOHNS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 CUMBERLAND ST
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-1909
Mailing Address - Country:US
Mailing Address - Phone:423-495-9126
Mailing Address - Fax:423-495-9145
Practice Address - Street 1:425 CUMBERLAND ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-1909
Practice Address - Country:US
Practice Address - Phone:423-495-9126
Practice Address - Fax:423-495-9145
Is Sole Proprietor?:No
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7667104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker