Individual provider · Type 1 NPI

Melita Travis Johnson, LMSW, CCDP

Clinical Social Worker · Grand Rapids, MI

NPI number 1376936104 Active

Practice location

770 Kenmoor Ave SE Ste 103
Grand Rapids, MI 49546-8602

Call (616) 481-9337 Map

Fax (616) 719-3119

Mailing address

1130 Elmdale St NE
Grand Rapids, MI 49525-2632

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X6801063274 (MI)

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 1376936104

Melita Travis Johnson, LMSW, CCDP's National Provider Identifier is 1376936104, issued on Mar 18, 2015. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Grand Rapids, MI. The record was last updated on Mar 18, 2015.