Provider Demographics
NPI:1316408354
Name:JOHNSON, KIRSTEN APRIL (LCSW)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:APRIL
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5810 OLD HARRISBURG RD
Mailing Address - Street 2:
Mailing Address - City:YORK SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:17372-8762
Mailing Address - Country:US
Mailing Address - Phone:717-353-6274
Mailing Address - Fax:
Practice Address - Street 1:18 S GEORGE ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17401-1400
Practice Address - Country:US
Practice Address - Phone:717-668-9306
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-30
Last Update Date:2019-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0200821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA14430394OtherCAQH