Individual
NICHOLAS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1312 WESTEN ST, BOWLING GREEN, KY 42104-3352
(270) 784-9630
(270) 904-1073
Mailing address
1312 WESTEN ST, BOWLING GREEN, KY 42104-3352
(270) 904-1072
(270) 904-1073
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
255710
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100753330
—
KY
Enumeration date
09/09/2018
Last updated
07/30/2021
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