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General NPI Number Information
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NPI Number | 1912776972
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Entity Type | Organization
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Legal Business Name | SUSAN C JOHNSON, LICSW, PLLC
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Dates
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Enumeration Date | 01/01/2024
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Last Update Date | 01/01/2024
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Provider Practice Location Address
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Address Line | 513 E 8TH ST
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City | PORT ANGELES
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State | WA
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Zip | 98362-6221
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Country | US
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Telephone | 360-775-9081
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Fax |
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Provider Business Mailing Address
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Address Line | 526 S LIBERTY ST
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City | PORT ANGELES
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State | WA
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Zip | 98362-6650
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Country | US
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Telephone | 859-699-0839
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Fax |
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Authorized Official
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Title or Position | LICSW
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Name | SUSAN C JOHNSON
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Credential | LICSW
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Telephone | 360-775-9081
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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 |
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License Number State |
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