| Rachael Johnson Llc | |
|
421 W 128th St S Jenks OK 74037-4415 | |
| (918) 232-4516 | |
| Not Available |
| Full Name | Rachael Johnson Llc |
|---|---|
| Speciality | Social Worker |
| Location | 421 W 128th St S, Jenks, Oklahoma |
| Authorized Official Name and Position | Rachael Johnson (LCSW) |
| Authorized Official Contact | 9182324516 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rachael Johnson Llc 421 W 128th St S Jenks OK 74037-4415 Ph: (918) 232-4516 | Rachael Johnson Llc 421 W 128th St S Jenks OK 74037-4415 Ph: (918) 232-4516 |
| NPI Number | 1922788421 |
|---|---|
| Provider Enumeration Date | 07/19/2023 |
| Last Update Date | 12/04/2023 |
| Certification Date | 12/04/2023 |
| Medicare PECOS PAC ID | 2062853625 |
|---|---|
| Medicare Enrollment ID | O20240514000988 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922788421 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Rachael Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821349689 PECOS PAC ID: 4082968607 Enrollment ID: I20240514001379 |
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