Individual provider Active NPI

Hostonia Segree Johnson, LCSW

  • Mental Health Counselor
  • Bradenton, FL
National Provider Identifier
1003634171
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
SW22483 Issued in FL
Practice address
101 Riverfront Blvd Ste 100
Bradenton, FL 34205-8870
Phone
(866) 936-5250
NPI assigned
Sep 28, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X SW22483 FL
Mental Health Counselor 101YM0800X SW22483 FL Primary

Addresses

Primary practice location

101 Riverfront Blvd Ste 100
Bradenton, FL 34205-8870

Mailing address

3222 Klays CT
Royal Palm Beach, FL 33411-8324
Phone (863) 228-3370

Other practice location 1

725 N 12th Ave Bldg B
Arcadia, FL 34266-8752
Phone (863) 494-1242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241028003542 FL Practitioner - Clinical Social Worker 8527591619 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MCR Health IncGroup PAC ID 7214847995, 132 clinicians
Health Care Center for the Homeless IncGroup PAC ID 6103895107, 51 clinicians
Ace Behavioral Health LLCGroup PAC ID 2668984675, 38 clinicians
Citrus County Rural Health IncGroup PAC ID 0648664698, 8 clinicians

Practice addresses (Care Compare)

12271 US Hwy 301 N
Parrish, FL 34219-8410
Phone (941) 713-2231

232 N Orange Blossom TRL
Orlando, FL 32805-1612
Phone 4074285751329

5406 Hoover Blvd
Suite 18
Tampa, FL 33634-5330
Phone (866) 770-4104

725 N 12TH Ave
B
Arcadia, FL 34266-8752
Phone (863) 494-1242

927 N Citrus Ave
Crystal River, FL 34428-3422
Phone (352) 565-7342

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW22483FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
MCR Health, Inc. Single Specialty CurrentSince Oct 17, 2024 Accepting new patients
Citrus County Rural Health Inc Single Specialty CurrentSince Sep 1, 2025 Accepting new patients
Ace Behavioral Health LLC Single Specialty CurrentSince May 1, 2025 Accepting new patients
MCR Health, Inc. CurrentSince Oct 17, 2024 Accepting new patients

Locations

725 N 12th Ave
Bldg B
Arcadia, FL 34266
Phone (863) 494-1242

101 Riverfront Blvd
Ste 710
Bradenton, FL 34205

927 N Citrus Ave
Crystal River, FL 34428
Phone (352) 404-5588

12271 US Highway 301 N
Parrish, FL 34219
Phone (941) 713-2231

5406 Hoover Blvd
Ste 18
Tampa, FL 33634
Phone (813) 880-7577

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1727481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1003634171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3222 KLAYS CT",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334118324",
            "telephone_number": "863-228-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 RIVERFRONT BLVD STE 100",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342058870",
            "telephone_number": "866-936-5250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 N 12th Ave Bldg B",
            "address_purpose": "LOCATION",
            "city": "Arcadia",
            "state": "FL",
            "postal_code": "342668752",
            "country_code": "US",
            "telephone_number": "863-494-1242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEGREE JOHNSON",
        "first_name": "HOSTONIA",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-28",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW22483",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW22483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.