Kimberly Petrae Johnson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

3292 Issued in KY

Practice address

137 E Main St
Georgetown, KY 40324-1786

Phone

(859) 312-6400

NPI assigned

Aug 13, 2009

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Kim Petrae Cron Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Georgetown Counseling Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Georgetown, KY
  • NPI 1669907994
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1250121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1679705479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 N BROADWAY ST",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403241305",
            "telephone_number": "859-312-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 E MAIN ST",
            "city": "GEORGETOWN",
            "state": "KY",
            "postal_code": "403241786",
            "telephone_number": "859-312-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KIMBERLY",
        "middle_name": "PETRAE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-13",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "3292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "CRON",
            "middle_name": "PETRAE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jem Counseling & Consulting
• John Bond Counseling, LLC
• Bayley Johnson
• Caleb Johnson, ATC,LAT
• Jane Marie Johnson, PHARMD
• Korey Johnson
• Martha Almira Johnson, APRN
• Phillip A Johnson, RPH
• Rachel Johnson, ARNP
• Frederick A Johnston, PHARM.D.

• Clinical Social Worker in Georgetown, KY
• Providers in Georgetown, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.