Provider Demographics
NPI:1841814662
Name:JOHNSON, ZOE M (PHD, LCSW)
Entity type:Individual
Prefix:DR
First Name:ZOE
Middle Name:M
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:DR
Other - First Name:ZOE
Other - Middle Name:M
Other - Last Name:MINOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, LCSW
Mailing Address - Street 1:269 TOWNS WALK DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-7977
Mailing Address - Country:US
Mailing Address - Phone:404-840-5250
Mailing Address - Fax:
Practice Address - Street 1:269 TOWNS WALK DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-7977
Practice Address - Country:US
Practice Address - Phone:404-840-5250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-08
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0038691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical