Individual provider · Type 1 NPI

Andra D. Johnson, LISW, LCSW, LCAC

Clinical Social Worker · Fort Wayne, IN

NPI number 1093787426 Active

Practice location

4656 W Jefferson Blvd, Suite 285
Fort Wayne, IN 46804-6857

Call (260) 422-9372 Map

Fax (260) 672-0859

Mailing address

11014 Constantia Cv
Roanoke, IN 46783-8910

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400X991842 (LICDC) (OH)
Clinical Social Worker 1041C0700XI - 0009358 (LISW) (OH)
Clinical Social Worker 1041C0700X2979-123 (LCSW) (WI)
Clinical Social Worker Primary 1041C0700X34005636A (LCSW) (IN)
Addiction (Substance Use Disorder) Counselor 101YA0400X87000438A (LCAC) (IN)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1093787426

Andra D. Johnson, LISW, LCSW, LCAC's National Provider Identifier is 1093787426, issued on Feb 1, 2006. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Fort Wayne, IN. The record was last updated on Oct 17, 2011.