# MRS. TRACEY L JOHNSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1396816385
- **Gender:** F
- **Credential:** L.I.S.W.-CP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | 6970 | SC | Yes |

## Other

- **Enumeration date:** 11/13/2006
- **Last updated:** 08/14/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 570629234006 | BCBS | SC |
| 01 | — | CJ5560 | RAILROAD MEDICARE | SC |