Kathryn Johnson, LCSW
Individual provider Active NPI Clinical Social Worker · Wrightsville, GA
NPI 1396934840 · NPPES record last updated Nov 6, 2008
Key facts
- NPI
- 1396934840
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- CSW003904 (GA)
- Practice address
- 508 W Elm St
Wrightsville, GA 31096-1224 - Phone
- (478) 864-3448
- Fax
- (478) 864-1288
- NPI assigned
- Oct 22, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|
| CSW003904 | GA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Senior Psych Solutions Corp | Clinical | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW003904 | GA | Yes |
Addresses
Primary practice location
508 W Elm St
Wrightsville, GA 31096-1224
Mailing address
PO Box 371
Wrightsville, GA 31096-0371
Phone (478) 864-3448
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CSW003904 | Other | GA | GEORGIA LICENSE |
| 407295341C | Medicaid | GA |
Other providers in Wrightsville, GA
- Christy Clyborne Jackson
- Johnson County Board of Health
- Johnson County Center for Community Health
- Johnson County Center for Community Health
- Johnson County Commissioner of Roads and Revenues
- Melissa Cheryl Kilgore
- Allison Lee
- Malissa Denae Martin
- Travis Lamar McClendon
- Clay Richard Mekelburg
All providers in Wrightsville, GA · Clinical Social Worker in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 6, 2008. 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.