MEDICARE: HEATHER MCBEE JOHNS 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
1	1041C0700X	Clinical Social Worker	2525	KS
2	1041C0700X	Clinical Social Worker	2011012442	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	35243018	OTHER		BCBS OF KC

General Provider Information

NPI Number	:	1639287915
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER MCBEE JOHNS LCSW

Provider Business Mailing Address
First Line	:	1432 SOUTHWEST BLVD
Second Line	:	PO BOX 1128
City	:	JEFFERSON CITY
State	:	MO
Zip	:	65102-1128
Country	:	US
Telephone Number	:	573-632-5560
Fax Number	:	573-632-5875

Provider Business Practice Location Address
First Line	:	1432 SOUTHWEST BLVD
Second Line	:
City	:	JEFFERSON CITY
State	:	MO
Zip	:	65102-1128
Country	:	US
Telephone Number	:	573-632-5560
Fax Number	:	573-632-5875

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2006
Last Update Date	:	03/25/2013

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