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General NPI Number Information
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NPI Number | 1588990881
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Entity Type | Individual
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Provider Name | BARRY DANIEL JOHNSON LCSW
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Gender | Male
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Dates
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Enumeration Date | 10/22/2009
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 2024 CHERRY HILL DR STE 201L
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City | COLUMBIA
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State | MO
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Zip | 65203-5921
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Country | US
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Telephone | 573-205-1279
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Fax | 573-203-5001
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Provider Business Mailing Address
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Address Line | 3900 DEERFOOT WAY
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City | COLUMBIA
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State | MO
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Zip | 65203-6758
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Country | US
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Telephone | 573-205-1279
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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 | 2009032380
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License Number State | MO
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