Provider Demographics
NPI:1104294453
Name:JOHNSON, AIMEE (LCSW, LSCSW)
Entity type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LCSW, LSCSW
Other - Prefix:MISS
Other - First Name:AIMEE
Other - Middle Name:
Other - Last Name:LEANOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1300 LOCUST ST STE E
Mailing Address - Street 2:
Mailing Address - City:HARRISONVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64701-1366
Mailing Address - Country:US
Mailing Address - Phone:816-884-4004
Mailing Address - Fax:816-884-3414
Practice Address - Street 1:1300 LOCUST ST STE E
Practice Address - Street 2:
Practice Address - City:HARRISONVILLE
Practice Address - State:MO
Practice Address - Zip Code:64701-1366
Practice Address - Country:US
Practice Address - Phone:816-884-4004
Practice Address - Fax:816-884-3414
Is Sole Proprietor?:No
Enumeration Date:2015-09-03
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20150121741041C0700X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No251S00000XAgenciesCommunity/Behavioral Health