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General NPI Number Information
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NPI Number | 1760680797
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Entity Type | Individual
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Provider Name | JODY A. JOHNSON LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/11/2007
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Last Update Date | 07/07/2022
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Provider Practice Location Address
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Address Line | 308 N LOCUST ST
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City | GRAND ISLAND
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State | NE
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Zip | 68801-5969
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Country | US
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Telephone | 402-225-6360
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Fax |
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Provider Business Mailing Address
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Address Line | 308 N LOCUST ST
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City | GRAND ISLAND
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State | NE
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Zip | 68801-5969
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Country | US
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Telephone | 402-225-6360
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Fax | 402-988-1565
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 8325
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 1238
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 111283
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License Number State | IA
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2166
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License Number State | NE
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Taxonomy #5
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1338
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License Number State | NE
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