Individual
KATHRYN M JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LBSW, QIDP
Contact information
Practice address
3353 LOUSMA DR SE, WYOMING, MI 49548-2251
(616) 248-6258
(616) 241-6470
Mailing address
3353 LOUSMA DR SE, WYOMING, MI 49548-2251
(616) 241-6258
(616) 241-6470
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
6802085815
MI
171M00000X
Case Manager/Care Coordinator
Primary
6802085815
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6802085815
BACHELOR OF SOCIAL WORK
MI
Enumeration date
01/15/2013
Last updated
02/25/2019
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