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NPI Code Detail

MEDICARE: KATHLEEN JOHNSON LCSW

MEDICARE: KATHLEEN 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 WorkerLCSW224851MA

General Provider Information

NPI Number : 1467218149
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN JOHNSON LCSW
Provider Business Mailing Address
First Line : 5 PRINCETON ST
Second Line :
City : WINDHAM
State : NH
Zip : 03087-2228
Country : US
Telephone Number : 617-816-7199
Fax Number :
Provider Business Practice Location Address
First Line : 800 DISTRICT AVE STE 520
Second Line :
City : BURLINGTON
State : MA
Zip : 01803-5060
Country : US
Telephone Number : 617-816-7199
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/21/2024
Last Update Date : 02/21/2024

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Directions to “ KATHLEEN JOHNSON LCSW” Practice Location

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