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Individual

MICHAEL KENDRICK JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
343 8TH ST NE, #E-2, ATLANTA, GA 30309-4282
(678) 895-8412
(404) 879-0779
Mailing address
343 8TH ST NE, #E-2, ATLANTA, GA 30309-4282
(678) 895-8412
(404) 879-0779

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW003882
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
316564733A
GA
Enumeration date
08/05/2008
Last updated
01/30/2012
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