Individual
CORLISS J. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S1501115
OH
104100000X
Social Worker
S150115
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2910854
—
OH
Enumeration date
08/28/2017
Last updated
07/06/2026
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