Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Charlie-Mae Johnson, LICSW

Individual provider Clinical Social Worker · NPI 1013871219

Charlie-Mae Johnson, LICSW is a Clinical Social Worker in Waterbury, Vermont. Practices as a sole proprietor. Licensed in Vermont.

Licensed in
VT
In the registry since
2025
What do these letters mean?
LICSW — Licensed Independent Clinical Social Worker
The title some states use for an independently practising clinical social worker.

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Practice location Address checks out

5 Pilgrim Park Rd
Waterbury, VT 05676-1735
Phone: (802) 474-1878
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 089.0136799PROV (VT)

Record details

NPI number1013871219
Entity typeIndividual (Type 1)
GenderFemale
Credentials LICSW
Sole proprietorYes
NPI enumeratedDecember 11, 2025
Last updated in NPPESDecember 11, 2025
Certification dateDecember 11, 2025

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