Kyla Marie Johnson

Individual provider Active NPI Clinical Social Worker · Salt Lick, KY

NPI 1881541977 · NPPES record last updated Mar 16, 2026

Key facts

NPI
1881541977
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
TC00001061 (KY)
Practice address
396 Cave Run Lake Rd
Salt Lick, KY 40371-8744
Phone
(606) 784-1153
NPI assigned
Mar 16, 2026
Sex
Female
Sole proprietor
No

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
TC00001061KYMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X TC00001061 KY Yes

Addresses

Primary practice location

396 Cave Run Lake Rd
Salt Lick, KY 40371-8744

Mailing address

396 Cave Run Lake Rd
Salt Lick, KY 40371-8744
Phone (606) 784-1153

Other providers in Salt Lick, KY

All providers in Salt Lick, KY · Clinical Social Worker in Kentucky

Sources for this page

Verify at the official NPI Registry.