| Doctor Name: | MICHAEL KENDRICK JOHNSON |
| NPI Number: | 1003072364 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCSW |
| License Number: | CSW003882 |
| Business Practice Address: | 343 8th St Ne #e-2 Atlanta, GA - 303094282 |
| Business Phone Number: | 6788958412 |
| Business Fax Number: | 4048790779 |
| Mailing Address: | 343 8th St Ne, #e-2 ATLANTA |
| State: | GA |
| Postal Code: | 303094282 |
| Phone Number: | 6788958412 |
| Fax Number: | 4048790779 |
| NPI Enumeration Date: | 08/05/2008 |
| NPI Last Update Date: | 01/30/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | CSW003882 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |