Provider Demographics
NPI:1205286911
Name:JOHNSON, AMY (MSW, LSW)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:ZIELINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LSW
Mailing Address - Street 1:735 HASKINS RD
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-1638
Mailing Address - Country:US
Mailing Address - Phone:419-354-7744
Mailing Address - Fax:
Practice Address - Street 1:10100 ELIDA RD
Practice Address - Street 2:
Practice Address - City:DELPHOS
Practice Address - State:OH
Practice Address - Zip Code:45833-9056
Practice Address - Country:US
Practice Address - Phone:419-695-8010
Practice Address - Fax:419-695-0565
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.14401721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2847496Medicaid