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NPI Code Detail

MEDICARE: LORI A JOHNSON LMSW

MEDICARE: LORI A JOHNSON LMSW
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
1164W00000XLicensed Practical Nurse4703053213MI
21041C0700XClinical Social Worker6801091425MI

General Provider Information

NPI Number : 1760614358
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORI A JOHNSON LMSW
Provider Business Mailing Address
First Line : 117 E PARK ST
Second Line :
City : MARQUETTE
State : MI
Zip : 49855-3624
Country : US
Telephone Number : 906-360-7472
Fax Number : 906-273-1177
Provider Business Practice Location Address
First Line : 102 W WASHINGTON ST STE 114
Second Line :
City : MARQUETTE
State : MI
Zip : 49855-4350
Country : US
Telephone Number : 906-360-7472
Fax Number : 906-273-1177
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2009
Last Update Date : 03/17/2018

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Directions to “ LORI A JOHNSON LMSW” Practice Location

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