Provider Demographics
NPI:1376783209
Name:JOHNSON, ELIZABETH ANNE J (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ANNE J
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
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Mailing Address - Street 1:2333 ALUMNI PARK PLZ
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-4012
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:740 S LIMESTONE ST
Practice Address - Street 2:ADOLESCENT MEDICINE J413
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0001
Practice Address - Country:US
Practice Address - Phone:859-323-5643
Practice Address - Fax:859-323-3795
Is Sole Proprietor?:No
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY32661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical