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NPI Code Detail

MEDICARE: GLORIA D JOHNSON LCSW-A

MEDICARE: GLORIA D JOHNSON LCSW-A
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 WorkerP023260NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2P023260OTHERNCNORTH CAROLINA SOCIAL WORK LICENSURE AND CERTIFICATION BOARD

General Provider Information

NPI Number : 1750925236
Entity Type Code : Individual
Provider Name (Legal Business Name) : GLORIA D JOHNSON LCSW-A
Provider Business Mailing Address
First Line : 5630 MURPHY RD
Second Line :
City : STEDMAN
State : NC
Zip : 28391-9062
Country : US
Telephone Number : 910-476-7977
Fax Number :
Provider Business Practice Location Address
First Line : 401 ROBESON ST
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28301-5635
Country : US
Telephone Number : 910-321-0069
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/29/2019
Last Update Date : 05/21/2026

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Directions to “ GLORIA D JOHNSON LCSW-A” Practice Location

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