Individual ProviderLeticia JohnsonCounselorBehavioral Health & Social Service ProvidersPractice Address911 N Buffalo Dr, #213, Las Vegas, NV 89128-0379(702) 942-1774(702) 412-9989PECOS EnrollmentBased on the most recent information from CMS, provider Leticia 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 5 days ago.Profile DetailsProvider ID1558799262Provider TypeIndividualFull NameJohnson, LeticiaGenderFemaleSole ProprietorYesEnumeration Date10/16/2013Last Updated10/16/2013Contact InformationPractice LocationPractice Address911 N Buffalo Dr, #213, Las Vegas, NV 89128-0379Phone(702) 942-1774FaxUnlisted FaxMailing LocationMailing Address663 Loughton St, Las Vegas, NV 89178-1219Phone(702) 412-9989FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer