Gennevieve Adrianne Johnson
Individual provider Active NPI Social Worker · Maxwelton, WV
NPI 1750101598 · NPPES record last updated Oct 16, 2024
Key facts
- NPI
- 1750101598
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- PL092116020 (WV)
- Practice address
- 804 Industrial Park Rd
Maxwelton, WV 24957-8066 - Phone
- (304) 497-0500
- NPI assigned
- Oct 16, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PL092116020 | WV | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker |
104100000X | PL092116020 | WV | Yes |
Addresses
Primary practice location
804 Industrial Park Rd
Maxwelton, WV 24957-8066
Mailing address
804 Industrial Park Rd
Maxwelton, WV 24957-8066
Other providers in Maxwelton, WV
- Jennifer Marie Highlander
- Christopher Wayne Holland
- Ralph Hubbard
- Noel B Jewell
- Cindy Johnson
- Alexis Jones
- Martha Jones
- Derek Kashola
- Kathryn Dayle Keaton
- Kristen Kenney
All providers in Maxwelton, WV · Social Worker in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2024. 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.