Individual
CHARLIE-MAE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
5 PILGRIM PARK RD, WATERBURY, VT 05676-1735
(802) 474-1878
Mailing address
324 DALTON RD, DALTON, NH 03598-5723
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
089.0136799PROV
VT
Other
Enumeration date
12/11/2025
Last updated
12/11/2025
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