MEDICARE: LATOYA JOHNSON MSW

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

General Provider Information

NPI Number	:	1881054880
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATOYA JOHNSON MSW

Provider Business Mailing Address
First Line	:	3055 LEBANON PIKE STE. 2102
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37214
Country	:	US
Telephone Number	:	615-945-0737
Fax Number	:

Provider Business Practice Location Address
First Line	:	3055 LEBANON PIKE STE 2102
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37214-2230
Country	:	US
Telephone Number	:	615-945-0737
Fax Number	:

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

Provider Enumeration Date	:	03/03/2016
Last Update Date	:	03/03/2016

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