Individual
KATHRYN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
508 W ELM ST, WRIGHTSVILLE, GA 31096-1224
(478) 864-3448
(478) 864-1288
Mailing address
PO BOX 371, WRIGHTSVILLE, GA 31096-0371
(478) 864-3448
(478) 864-1288
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW003904
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
407295341C
—
GA
01
—
CSW003904
GEORGIA LICENSE
GA
Enumeration date
10/22/2007
Last updated
11/06/2008
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