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General NPI Number Information
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NPI Number | 1144115098
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Entity Type | Individual
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Provider Name | KAITLIN JOHNSON LMSW
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Gender | Female
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Dates
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Enumeration Date | 06/11/2025
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 22655 WASHINGTON ST
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City | LEONARDTOWN
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State | MD
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Zip | 20650-3848
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Country | US
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Telephone | 301-507-9521
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Fax | 312-260-7996
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Provider Business Mailing Address
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Address Line | 45950 E SUNRISE DR
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City | LEXINGTON PARK
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State | MD
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Zip | 20653-6338
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Country | US
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Telephone | 607-344-1355
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Fax | 607-344-1355
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 31585
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License Number State | MD
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