| Doctor Name: | MS. KATHY PAINTER JOHNSON |
| NPI Number: | 1063762078 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW-A |
| License Number: | P007141 |
| Business Practice Address: | 10241 Blackwell Rd Se Leland, NC - 284518515 |
| Business Phone Number: | 9103715300 |
| Business Fax Number: | 9103715302 |
| Mailing Address: | 10241 Blackwell Rd Se, LELAND |
| State: | NC |
| Postal Code: | 284518515 |
| Phone Number: | 9103715300 |
| Fax Number: | 9103715302 |
| NPI Enumeration Date: | 09/17/2012 |
| NPI Last Update Date: | 09/17/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | P007141 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |