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NPI Code Detail

MEDICARE: LAKEITHA JOHNSON LCSW, MSW, CAT

MEDICARE: LAKEITHA JOHNSON LCSW, MSW, CAT
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
1101YM0800XMental Health Counselor
21041C0700XClinical Social WorkerCSW.09932436CO

General Provider Information

NPI Number : 1700578705
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAKEITHA JOHNSON LCSW, MSW, CAT
Provider Business Mailing Address
First Line : 18638 E 42ND AVE
Second Line :
City : DENVER
State : CO
Zip : 80249-7268
Country : US
Telephone Number : 720-296-3434
Fax Number :
Provider Business Practice Location Address
First Line : 4455 E 12TH AVE
Second Line :
City : DENVER
State : CO
Zip : 80220-2415
Country : US
Telephone Number : 303-504-7700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2023
Last Update Date : 12/17/2025

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