Provider Demographics
NPI:1821040346
Name:JOHNSON, CHERYL (MSW)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6135 MEMORIAL DR
Mailing Address - Street 2:SUITE 100A
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-9000
Mailing Address - Country:US
Mailing Address - Phone:614-792-0114
Mailing Address - Fax:614-792-0114
Practice Address - Street 1:6135 MEMORIAL DR
Practice Address - Street 2:SUITE 100A
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-9000
Practice Address - Country:US
Practice Address - Phone:614-792-0114
Practice Address - Fax:614-792-0114
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1.00016641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical