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General NPI Number Information
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NPI Number | 1255698205
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Entity Type | Individual
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Provider Name | SCOTT KENNETH JOHNSON MSW, LICSW, LCSW
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Gender | Male
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Dates
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Enumeration Date | 04/16/2012
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 101 MAIN ST W STE 205
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City | ASHLAND
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State | WI
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Zip | 54806-1668
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Country | US
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Telephone | 715-575-4322
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 631
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City | ASHLAND
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State | WI
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Zip | 54806-0631
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Country | US
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Telephone | 715-575-4322
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 21082
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 8473
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License Number State | WI
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