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NPI Code Detail

MEDICARE: MS. SHANNON COCHRANCE JOHNSON LCSW

MEDICARE: MS. SHANNON COCHRANCE 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
1104100000XSocial Worker3572KY
21041C0700XClinical Social Worker3572KY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174655237
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHANNON COCHRANCE JOHNSON LCSW
Provider Business Mailing Address
First Line : 2250 THUNDERSTICK DR STE 1104
Second Line :
City : LEXINGTON
State : KY
Zip : 40505-9009
Country : US
Telephone Number : 859-254-1035
Fax Number : 859-254-2075
Provider Business Practice Location Address
First Line : 2250 THUNDERSTICK DR STE 1104
Second Line :
City : LEXINGTON
State : KY
Zip : 40505-9009
Country : US
Telephone Number : 859-254-1035
Fax Number : 859-254-2075
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2007
Last Update Date : 10/02/2019

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Directions to “ MS. SHANNON COCHRANCE JOHNSON LCSW” Practice Location

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