Individual provider · Type 1 NPI
Kettely Jeanne Johnson, LCSW
Clinical Social Worker · Fayetteville, GA
Practice location
510 Thatch Ter
Fayetteville, GA 30214-1919
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinical Social Worker Primary | 1041C0700X | CSW004568 (GA) |
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 1114845385
Kettely Jeanne Johnson, LCSW's National Provider Identifier is 1114845385, issued on Jul 7, 2026. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Fayetteville, GA. The record was last updated on Jul 7, 2026.