Provider Demographics
NPI:1407633662
Name:JOHNSON, ALEXUS DANIELLE (CSW)
Entity type:Individual
Prefix:MS
First Name:ALEXUS
Middle Name:DANIELLE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1945 E 70TH ST STE E-2
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-5347
Mailing Address - Country:US
Mailing Address - Phone:318-227-4999
Mailing Address - Fax:318-300-1149
Practice Address - Street 1:1945 E 70TH ST # 2
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5347
Practice Address - Country:US
Practice Address - Phone:318-227-4999
Practice Address - Fax:318-300-1149
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-12
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA194291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical