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NPI Code Detail

MEDICARE: ISABELLE JANE JOHNSON MSW, LCSWA

MEDICARE: ISABELLE JANE JOHNSON MSW, LCSWA
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 WorkerP022533NC

General Provider Information

NPI Number : 1245112721
Entity Type Code : Individual
Provider Name (Legal Business Name) : ISABELLE JANE JOHNSON MSW, LCSWA
Provider Business Mailing Address
First Line : 1327 SEA MIST DR
Second Line :
City : MATTHEWS
State : NC
Zip : 28105-6640
Country : US
Telephone Number : 704-290-9693
Fax Number :
Provider Business Practice Location Address
First Line : 9719 NORTHEAST PKWY STE 100
Second Line :
City : MATTHEWS
State : NC
Zip : 28105-9713
Country : US
Telephone Number : 704-237-4240
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2025
Last Update Date : 07/24/2025

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