Provider Demographics
NPI:1073713152
Name:JOHNSON, RENEE MARIE (MSW LCSW CAC III)
Entity Type:Individual
Prefix:MS
First Name:RENEE
Middle Name:MARIE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MSW LCSW CAC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5759 S LANSING WAY
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4107
Mailing Address - Country:US
Mailing Address - Phone:303-898-5782
Mailing Address - Fax:303-780-9192
Practice Address - Street 1:50 W 5TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-5103
Practice Address - Country:US
Practice Address - Phone:303-780-9191
Practice Address - Fax:303-780-9192
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLCSW 9912301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical