MEDICARE: MRS. DONNA MICHELLE JOHNSON LICSW

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	1041C0700X	Clinical Social Worker	LC23582	ME
2	1041C0700X	Clinical Social Worker	3523C	AL
3	1041C0700X	Clinical Social Worker	CSW09931567	CO
4	1041C0700X	Clinical Social Worker	44SC06500000	NJ
5	1041C0700X	Clinical Social Worker	9727	TN
6	1041C0700X	Clinical Social Worker	4371153	ID
7	1041C0700X	Clinical Social Worker	127961	MA

General Provider Information

NPI Number	:	1518628874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DONNA MICHELLE JOHNSON LICSW

Provider Business Mailing Address
First Line	:	35884 CRAMBLITT LN
Second Line	:
City	:	BAY MINETTE
State	:	AL
Zip	:	36507-8147
Country	:	US
Telephone Number	:	504-994-4846
Fax Number	:

Provider Business Practice Location Address
First Line	:	35884 CRAMBLITT LN
Second Line	:
City	:	BAY MINETTE
State	:	AL
Zip	:	36507-8147
Country	:	US
Telephone Number	:	504-994-4846
Fax Number	:

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

Provider Enumeration Date	:	01/07/2022
Last Update Date	:	01/06/2026

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Directions to “ MRS. DONNA MICHELLE JOHNSON LICSW” Practice Location

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