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NPI Code Detail

MEDICARE: LINDSEY JOHNSON LCSW

MEDICARE: LINDSEY 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
11041C0700XClinical Social WorkerP012890NC
21041C0700XClinical Social WorkerC013344NC

General Provider Information

NPI Number : 1417502386
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDSEY JOHNSON LCSW
Provider Business Mailing Address
First Line : 615 SHIPYARD BLVD
Second Line :
City : WILMINGTON
State : NC
Zip : 28412-6431
Country : US
Telephone Number : 910-772-2515
Fax Number :
Provider Business Practice Location Address
First Line : 1806 S 15TH ST
Second Line :
City : WILMINGTON
State : NC
Zip : 28401-6479
Country : US
Telephone Number : 910-772-2515
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2019
Last Update Date : 03/09/2021

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Directions to “ LINDSEY JOHNSON LCSW” Practice Location

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