Mr Kurt M Johnson, LCSW | |
1606 Broad St, Phenix City, AL 36867-5081 | |
(334) 480-8888 | |
Not Available |
Full Name | Mr Kurt M Johnson |
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Gender | Male |
Speciality | Social Worker - Clinical |
Location | 1606 Broad St, Phenix City, Alabama |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1134465263 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | 149.014379 (Illinois) | Secondary |
1041C0700X | Social Worker - Clinical | 4127C (Alabama) | Primary |
Entity Name | Personal Recovery Network Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1881990869 PECOS PAC ID: 5092611384 Enrollment ID: O20120110000096 |
Mailing Address | Practice Location Address |
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Mr Kurt M Johnson, LCSW 3700 Bridgewater Rd Apt C8, Columbus, GA 31909-6309 Ph: (309) 631-0058 | Mr Kurt M Johnson, LCSW 1606 Broad St, Phenix City, AL 36867-5081 Ph: (334) 480-8888 |
Elizabeth Parks, LICSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 146 Lee Road 2144, Phenix City, AL 36870 Phone: 706-392-3033 | |
Erica Fox, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1500 11th Ave, Phenix City, AL 36867 Phone: 334-560-5393 | |
Megan Marie Doxtator, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1502 11th Ave, Phenix City, AL 36867 Phone: 334-560-5393 Fax: 334-560-5242 | |
Gabrielle Krystyna Thomas, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 5295 Riverchase Dr Apt 1508, Phenix City, AL 36867 Phone: 229-942-9159 | |
Nga Nguyen, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1701 37th St, Phenix City, AL 36867 Phone: 703-244-5108 | |
Mr. Eric Graves Sr., LICSW, PIP Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2809 Creekstone Ln, Phenix City, AL 36867 Phone: 706-442-5270 |