Kimberly Diane Johnson, L.C.S.W.
Individual provider Active NPI Clinical Social Worker · Bennington, KS
NPI 1124063151 · NPPES record last updated Jan 28, 2025
Key facts
- NPI
- 1124063151
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 06394 (KS)
- Practice address
- 88 Alpine Ridge LN
Bennington, KS 67422-9070 - Phone
- (281) 682-4123
- NPI assigned
- Jun 16, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37034 | TX | MD | Clinical Neuropsychologist |
| 06394 | KS | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 06394 | KS | Yes |
Addresses
Primary practice location
88 Alpine Ridge LN
Bennington, KS 67422-9070
Mailing address
88 Alpine Ridge LN
Bennington, KS 67422-9070
Phone (281) 682-4123
Other providers in Bennington, KS
- Amy Elizabeth Adams
- Jill Hellmer Ahlers
- Bennington Ambulance Service
- Kathleen Ann Laflen
- Premier Home Care Inc.
- Romm Chiropractic LLC
- Charles Nelson Romm Jr.
- Usd 240 Twin Valley
All providers in Bennington, KS · Clinical Social Worker in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.