Provider Demographics
NPI:1265739700
Name:JOHNSON, CARA LYNNE (LICSW)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:LYNNE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:CARA
Other - Middle Name:LYNN
Other - Last Name:SMETHURST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:82 WATERCOURSE PL
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-3626
Mailing Address - Country:US
Mailing Address - Phone:781-799-7350
Mailing Address - Fax:
Practice Address - Street 1:833 SHAWMUT AVE.
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02746
Practice Address - Country:US
Practice Address - Phone:508-714-7044
Practice Address - Fax:508-221-1355
Is Sole Proprietor?:No
Enumeration Date:2011-02-18
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1179121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical