Cheryl Ann Johnson | Jackson, MS • PECOS Search

Cheryl Ann Johnson

Psychologist

Behavioral Health & Social Service Providers

1500 E Woodrow Wilson Ave, 116a2, Jackson, MS 39216-5116

PECOS Enrollment

Based on the most recent information from CMS, provider Cheryl Ann Johnson does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1407862113
Provider Type
Individual
Full Name
Johnson, Cheryl Ann
Credential
PHD

Gender
Female
Sole Proprietor
No
Enumeration Date
8/1/2006
Last Updated
7/8/2007

Contact Information

Practice Location

1500 E Woodrow Wilson Ave, 116a2, Jackson, MS 39216-5116

Unlisted Fax

Mailing Location

5305 Red Fox Rd, Jackson, MS 39211-4627

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 103TC0700X Primary	Description Psychologist Behavioral Health & Social Service Providers	License 29-419 Mississippi