Provider Demographics
NPI:1366598112
Name:JOHNSON, CHRISTY L (MSW)
Entity type:Individual
Prefix:
First Name:CHRISTY
Middle Name:L
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 CUTTER CREEK
Mailing Address - Street 2:P.O. BOX 1011
Mailing Address - City:CLINTWOOD
Mailing Address - State:VA
Mailing Address - Zip Code:24228-1109
Mailing Address - Country:US
Mailing Address - Phone:276-926-6132
Mailing Address - Fax:
Practice Address - Street 1:133 MCCLURE AVE
Practice Address - Street 2:
Practice Address - City:CLINTWOOD
Practice Address - State:VA
Practice Address - Zip Code:24228-0309
Practice Address - Country:US
Practice Address - Phone:276-926-1680
Practice Address - Fax:276-926-9179
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator