Anne Marie Johnson, LCSW

Individual provider Active NPI Clinical Social Worker · Wales, WI

NPI 1790296259 · NPPES record last updated Oct 23, 2017

Key facts

NPI
1790296259
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
564-123 (WI)
Practice address
S8W31381 Margaret Mary CT
Wales, WI 53183-9715
Phone
(414) 349-2962
NPI assigned
Oct 23, 2017
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
564WIMDClinical Child & Adolescent Psychologist
564-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Anne Johnson, LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 564-123 WI Yes

Addresses

Primary practice location

S8W31381 Margaret Mary CT
Wales, WI 53183-9715

Mailing address

S8W31381 Margaret Mary CT
Wales, WI 53183-9715
Phone (414) 349-2962

Other providers in Wales, WI

All providers in Wales, WI · Clinical Social Worker in Wisconsin

Sources for this page

Verify at the official NPI Registry.