| Holly R Johnson, Lcsw | |
|
1041 Oconee Forest Ln Watkinsville GA 30677-2323 | |
| (706) 207-7683 | |
| (706) 850-0899 |
| Full Name | Holly R Johnson, Lcsw |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1041 Oconee Forest Ln, Watkinsville, Georgia |
| Authorized Official Name and Position | Holly R Johnson (OWNER/DIRECTOR) |
| Authorized Official Contact | 7062077683 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Holly R Johnson, Lcsw 1041 Oconee Forest Ln Watkinsville GA 30677-2323 Ph: (706) 207-7683 | Holly R Johnson, Lcsw 1041 Oconee Forest Ln Watkinsville GA 30677-2323 Ph: (706) 207-7683 |
| NPI Number | 1962683615 |
|---|---|
| Provider Enumeration Date | 11/23/2007 |
| Last Update Date | 06/30/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962683615 | NPI | - | NPPES |
| 204083042A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CSW003573 (Georgia) | Primary |
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