MEDICARE: KAMELA ROSE JOHNSON LSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	SW142720	PA

General Provider Information

NPI Number	:	1124910773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAMELA ROSE JOHNSON LSW

Provider Business Mailing Address
First Line	:	1700 PINE ST APT 2F
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-6721
Country	:	US
Telephone Number	:	267-670-6883
Fax Number	:

Provider Business Practice Location Address
First Line	:	1700 PINE ST APT 2F
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-6721
Country	:	US
Telephone Number	:	267-670-6883
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2025
Last Update Date	:	06/05/2026

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Directions to “ KAMELA ROSE JOHNSON LSW” Practice Location

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