MEDICARE: HEATHER JOHNSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	1101045	OH

General Provider Information

NPI Number	:	1093179236
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER JOHNSON

Provider Business Mailing Address
First Line	:	600 W 3RD ST
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44906-2633
Country	:	US
Telephone Number	:	419-522-6191
Fax Number	:	419-525-6723

Provider Business Practice Location Address
First Line	:	600 W 3RD ST
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44906-2633
Country	:	US
Telephone Number	:	419-522-6191
Fax Number	:	419-525-6723

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2016
Last Update Date	:	02/06/2026

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Directions to “ HEATHER JOHNSON ” Practice Location

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