Individual ProviderShaterika L JohnsonCounselorBehavioral Health & Social Service ProvidersPractice Address204 Airport Road, Vidalia, LA 71373(318) 323-1300PECOS EnrollmentBased on the most recent information from CMS, provider Shaterika L 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 ID1417479346Provider TypeIndividualFull NameJohnson, Shaterika LGenderFemaleSole ProprietorYesEnumeration Date7/12/2017Last Updated7/21/2022Contact InformationPractice LocationPractice Address204 Airport Road, Vidalia, LA 71373Phone(318) 323-1300Fax(318) 323-1400Mailing LocationMailing Address204 Airport Rd, Vidalia, LA 71373-3449Phone(318) 323-1300Fax(318) 323-1400Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerLouisiana