Provider Demographics
NPI:1285923417
Name:JOHNSON, CHRISTINE E (MSW)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:E
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:E
Other - Last Name:BECKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:702 W ALTO RD
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46902-4907
Mailing Address - Country:US
Mailing Address - Phone:317-876-3699
Mailing Address - Fax:
Practice Address - Street 1:1311 W 96TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1191
Practice Address - Country:US
Practice Address - Phone:317-876-3699
Practice Address - Fax:574-537-2652
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker