Individual
KIMBERLY MARIA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, CSAC
Contact information
Practice address
700 WEST AVE S, LA CROSSE, WI 54601-8806
(608) 785-0940
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
18207-130
WI
1041C0700X
Clinical Social Worker
Primary
9555
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003150004
—
WI
Enumeration date
08/16/2017
Last updated
11/04/2024
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