Individual
MS. SHANNON COCHRANCE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2250 THUNDERSTICK DR STE 1104, LEXINGTON, KY 40505-9009
(859) 254-1035
(859) 254-2075
Mailing address
2250 THUNDERSTICK DR STE 1104, LEXINGTON, KY 40505-9009
(859) 254-1035
(859) 254-2075
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
3572
KY
1041C0700X
Clinical Social Worker
Primary
3572
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100276060
—
KY
Enumeration date
03/12/2007
Last updated
10/02/2019
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