Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 30 days.

KETTELY JEANNE JOHNSON LCSW
NPI 1114845385
Social Worker - Clinical in Fayetteville, GA

Active since July 07, 2026
510 THATCH TER, FAYETTEVILLE, GA 30214(470) 471-5708 Get Directions Write a Review

NPPES record added: July 7, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kettely Jeanne Johnson Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KETTELY JEANNE JOHNSON LCSW (NPI 1114845385) is an individual clinical provider in Fayetteville, Georgia, licensed in Georgia (CSW004568) and active in the NPI registry since July 2026.

NPPES Registry Identity

NPI1114845385
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKETTELY JEANNE JOHNSONCredential: LCSW
Location Address510 THATCH TERFayetteville, GA 30214-1919
Mailing Address510 Thatch TerFayetteville, GA 30214-1919 · (470) 471-5708
Sole ProprietorYes
Enumeration DateJuly 7, 2026
NPPES CertifiedJuly 7, 2026
NPI 1114845385 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License Licensed in GA · CSW004568
Definition
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 interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
510 THATCH TER, Fayetteville, GA 30214

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kettely Johnson's NPI number?

The NPI number for Kettely Johnson is 1114845385. It was assigned to this individual provider in the NPPES registry on July 7, 2026.

Where is Kettely Johnson located?

Kettely Johnson practices at 510 Thatch Ter, Fayetteville, GA 30214. The listed phone number is (470) 471-5708.

What is Kettely Johnson's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Kettely Johnson was last updated on July 7, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 28 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.