1699884502 NPI number — MS. RHONDA G. JOHNSON LCSW

Table of content: MS. RHONDA G. JOHNSON LCSW (NPI 1699884502)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699884502 NPI number — MS. RHONDA G. JOHNSON LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JOHNSON
Provider First Name:
RHONDA
Provider Middle Name:
G.
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
JOHNSON
Provider Other First Name:
RHONDA
Provider Other Middle Name:
JANE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1699884502
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/02/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1830 DESTINY LN
Provider Second Line Business Mailing Address:
SUITE 106
Provider Business Mailing Address City Name:
BOWLING GREEN
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42104-1087
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-904-5195
Provider Business Mailing Address Fax Number:
270-904-3648

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1830 DESTINY LN
Provider Second Line Business Practice Location Address:
SUITE 106
Provider Business Practice Location Address City Name:
BOWLING GREEN
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42104-1087
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-904-5195
Provider Business Practice Location Address Fax Number:
270-904-3648
Provider Enumeration Date:
08/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  1621 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 461528239 . This is a "IRS DEPARTMENT OF THE TREASURY" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com