Individual ProviderAmber J JohnsonCounselorBehavioral Health & Social Service ProvidersPractice Address1644 Carter St, Vidalia, LA 71373-3143(313) 414-3065PECOS EnrollmentBased on the most recent information from CMS, provider Amber J Johnson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:54 AM.Profile DetailsProvider ID1043782774Provider TypeIndividualFull NameJohnson, Amber JGenderFemaleSole ProprietorNoEnumeration Date12/19/2018Last Updated12/19/2018Contact InformationPractice LocationPractice Address1644 Carter St, Vidalia, LA 71373-3143Phone(313) 414-3065FaxUnlisted FaxMailing LocationMailing Address1644 Carter St, Vidalia, LA 71373-3143PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer