Individual
MRS. NICOLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
620 SOUTH LAUREL STREET, PINE BLUFF, AR 71601
(870) 534-4900
(501) 534-4906
Mailing address
620 SOUTH LAUREL STREET, PINE BLUFF, AR 71601
(870) 534-4900
(501) 534-4906
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
1868-M
AR
1041C0700X
Clinical Social Worker
Primary
2235-C
AR
Other
Enumeration date
12/18/2006
Last updated
05/17/2022
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