Individual
JENNIFER JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1312 WESTEN ST, BOWLING GREEN, KY 42104-3352
(270) 784-0724
(270) 904-1073
Mailing address
1312 WESTEN ST, BOWLING GREEN, KY 42104-3352
(270) 784-0724
(270) 904-1073
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
5927
KY
1041C0700X
Clinical Social Worker
Primary
252186
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100416670
—
KY
Enumeration date
06/24/2014
Last updated
10/18/2022
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