MEDICARE: MS. NYREE JOHNSON LCSW

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	104100000X	Social Worker
2	1041C0700X	Clinical Social Worker	21881	FL

General Provider Information

NPI Number	:	1154693646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NYREE JOHNSON LCSW

Provider Business Mailing Address
First Line	:	6982 WALKER FARMS DR
Second Line	:
City	:	BARTLETT
State	:	TN
Zip	:	38002-2524
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6982 WALKER FARMS DR
Second Line	:
City	:	BARTLETT
State	:	TN
Zip	:	38002-2524
Country	:	US
Telephone Number	:	407-797-4299
Fax Number	:

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

Provider Enumeration Date	:	01/31/2012
Last Update Date	:	08/20/2024

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