# KATHRYN M JOHNSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1770820474
- **Gender:** F
- **Credential:** LBSW, QIDP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 104100000X | Social Worker | 6802085815 | MI | — |
| 171M00000X | Case Manager/Care Coordinator | 6802085815 | MI | Yes |

## Other

- **Enumeration date:** 01/15/2013
- **Last updated:** 02/25/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 6802085815 | BACHELOR OF SOCIAL WORK | MI |