Vanessa M Johnston, L.C.S.W.

Individual provider Active NPI Clinical Social Worker · Aurora, MO

NPI 1871801969 · NPPES record last updated Sep 22, 2010

Key facts

NPI
1871801969
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
2006005449 (MO)
Practice address
903 Sunshine Dr
Aurora, MO 65605-1955
Phone
(417) 678-5361
NPI assigned
Sep 22, 2010
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

LicenseStateTypeSpecialty
2006005449MOMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2006005449 MO Yes

Addresses

Primary practice location

903 Sunshine Dr
Aurora, MO 65605-1955

Mailing address

903 Sunshine Dr
Aurora, MO 65605-1955
Phone (417) 678-5361

Other providers in Aurora, MO

All providers in Aurora, MO · Clinical Social Worker in Missouri

Sources for this page

Verify at the official NPI Registry.