DR. Larry Norman Johannessen, PHD MSW LCSW MDIV

NPI #1043488703 in Jacksonville, North Carolina

Provider Information

NPI Number: 1043488703
Entity Type: Individual
Name: DR. Larry Norman Johannessen, PHD MSW LCSW MDIV
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker
Credential: PHD MSW LCSW MDIV
Enumeration Date: Feb 15, 2008
Last Updated: Feb 15, 2008

Practice Location

Address: 825 GUMBRANCH RD
Address 2: SUITE 109
City: Jacksonville
State: North Carolina
ZIP Code: 28540
Phone: (910) 455-5551

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker	104100000X	Primary

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