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General NPI Number Information
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NPI Number | 1780930586
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Entity Type | Individual
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Provider Name | JULIE LYNN JOHNSON LCSW, ACSW
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Gender | Female
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Dates
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Enumeration Date | 07/30/2012
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 1724 VILLAGE WAY STE B
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City | ORANGE PARK
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State | FL
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Zip | 32073-5225
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Country | US
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Telephone | 904-654-3275
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 351198
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City | JACKSONVILLE
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State | FL
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Zip | 32235-1198
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Country | US
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Telephone | 904-654-3275
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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 | SW11790
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License Number State | FL
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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 | 2008012852
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW004330
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW11790
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License Number State | FL
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