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NPI Code Detail

MEDICARE: AMY JOHNSON MSW, LSW

MEDICARE:   AMY  JOHNSON  MSW, LSW
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
11041C0700XClinical Social WorkerS.1440172OH

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 : 1205286911
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY JOHNSON MSW, LSW
Provider Business Mailing Address
First Line : 1840 E GYPSY LANE RD
Second Line :
City : BOWLING GREEN
State : OH
Zip : 43402-9173
Country : US
Telephone Number : 419-354-9049
Fax Number : 419-353-1464
Provider Business Practice Location Address
First Line : 1840 E GYPSY LANE RD
Second Line :
City : BOWLING GREEN
State : OH
Zip : 43402-9173
Country : US
Telephone Number : 419-354-8402
Fax Number : 419-353-1464
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2016
Last Update Date : 12/09/2025

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