Provider Demographics
NPI:1720356223
Name:JOHNSON, KATHERINE RH (MSW, APSW)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:RH
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MSW, APSW
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:R
Other - Last Name:HETCHLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 N 1ST ST
Mailing Address - Street 2:
Mailing Address - City:COLBY
Mailing Address - State:WI
Mailing Address - Zip Code:54421-9633
Mailing Address - Country:US
Mailing Address - Phone:715-223-3678
Mailing Address - Fax:
Practice Address - Street 1:120 S BARSTOW ST
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-3642
Practice Address - Country:US
Practice Address - Phone:715-223-3678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-12
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI130373-1211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical