Provider Demographics
NPI:1912036153
Name:JOHNSON, BARBARA J (MSW)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:J
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:BARBARA
Other - Middle Name:LOHMAN
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:2975 BROADMOOR VALLEY RD
Mailing Address - Street 2:STE. 103
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-4466
Mailing Address - Country:US
Mailing Address - Phone:719-576-1978
Mailing Address - Fax:719-576-1979
Practice Address - Street 1:2975 BROADMOOR VALLEY RD
Practice Address - Street 2:STE. 103
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-4466
Practice Address - Country:US
Practice Address - Phone:719-576-1978
Practice Address - Fax:719-576-1979
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2014-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9870151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO987015OtherLCSW
CO987015OtherLCSW