Individual
MARY GRACE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW
Contact information
Practice address
245 FOUNTAIN CT STE 225, LEXINGTON, KY 40509-2794
(859) 323-6021
(859) 323-1670
Mailing address
543 W THIRD ST, LEXINGTON, KY 40508-1259
(859) 967-4453
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
259485
KY
Other
Enumeration date
10/01/2024
Last updated
02/04/2025
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