Individual
COURTNEY ANNE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5065
Mailing address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
(417) 761-5065
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
2018022860
MO
1041C0700X
Clinical Social Worker
Primary
2021003919
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14280877
CAQH
MO
05
—
490056628
—
MO
Enumeration date
07/11/2018
Last updated
03/31/2021
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