Individual
MRS. ANGELA D JOHNSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW-S
Contact information
Practice address
204 COOK RD, LEBANON, OH 45036
(513) 228-7800
(513) 725-2231
Mailing address
204 COOK RD STE 400, LEBANON, OH 45036-9600
(513) 228-7800
(513) 725-2231
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I.0008277-SUPV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000246037
ANTHEM PIN
OH
01
—
11689424
CAQH #
—
Enumeration date
03/03/2006
Last updated
06/13/2018
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