Active NPI
Camellia A Johnson, LCSW,MSW,BA
- Clinical Social Worker
- Torrington, CT
National Provider Identifier
1023459716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 9336
- Practice address
- 30 Peck Rd
Torrington Clinical Services BLDG 2 Suite 2203
Torrington, CT 06790-6123 - Phone
- (860) 626-7007
- Fax
- (860) 626-7014
- NPI assigned
- Jul 10, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 9336 | CT | Primary |
Addresses
Primary practice location
30 Peck Rd
Torrington Clinical Services BLDG 2 Suite 2203
Torrington, CT 06790-6123
Mailing address
141 E Main St
4TH Floor Administration
Waterbury, CT 06702-2310
Phone (203) 574-9000
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 060669107 | Other | CT | OPTUM BEHAVIORAL HEALTH WELLMORE GRP/FACILITY |
| 060669107 | Other | CT | UBH-CONNECTICARE WELLMORE GRP/FACILITY |
| 13671479 | Other | CT | CAQH |
| 060669107 | Other | CT | ANTHEM BCBS OF CT WELLMORE GRP/FACILITY |
| PENDING | Other | CT | MHN MANAGED HEALTH NETWORK |
| PENDING | Other | CT | CIGNA BEHAVIORAL HEALTH |
| 060669107 | Other | CT | HEALTHYCT WELLMORE GRP/FACILITY |
| PENDING | Other | CT | AETNA BEHAVIORAL HEALTH |
| TORRINGTON D339230 | Other | CT | BEACON HEALTH |
| 008064941 | Medicaid | CT | |
| 060669107 | Other | CT | UBH OXFORD HEALTH LIBERTY/FREEDOM WELLMORE GRP/FACILITY |
| 060669107 | Other | CT | UBH-UNITED HEALTHCARE WELLMORE GRP/FACILITY |
| PENDING | Other | CT | MHN TRICARENORTH |
Other names 1
- Camellia A Redway
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9336 | CT | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1373414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472428800000",
"number": "1023459716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "141 E MAIN ST",
"address_2": "4TH FLOOR ADMINISTRATION",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067022310",
"telephone_number": "203-574-9000",
"fax_number": "203-574-9006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 PECK RD",
"address_2": "TORRINGTON CLINICAL SERVICES BLDG 2 SUITE 2203",
"city": "TORRINGTON",
"state": "CT",
"postal_code": "067906123",
"telephone_number": "860-626-7007",
"fax_number": "860-626-7014"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "CAMELLIA",
"middle_name": "A",
"credential": "LCSW,MSW,BA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-10",
"last_updated": "2016-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "9336",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTUM BEHAVIORAL HEALTH WELLMORE GRP/FACILITY",
"identifier": "060669107",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UBH-CONNECTICARE WELLMORE GRP/FACILITY",
"identifier": "060669107",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "13671479",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BCBS OF CT WELLMORE GRP/FACILITY",
"identifier": "060669107",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN MANAGED HEALTH NETWORK",
"identifier": "PENDING",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA BEHAVIORAL HEALTH",
"identifier": "PENDING",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHYCT WELLMORE GRP/FACILITY",
"identifier": "060669107",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA BEHAVIORAL HEALTH",
"identifier": "PENDING",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEACON HEALTH",
"identifier": "TORRINGTON D339230",
"state": "CT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "008064941",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UBH OXFORD HEALTH LIBERTY/FREEDOM WELLMORE GRP/FACILITY",
"identifier": "060669107",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UBH-UNITED HEALTHCARE WELLMORE GRP/FACILITY",
"identifier": "060669107",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN TRICARENORTH",
"identifier": "PENDING",
"state": "CT"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CAMELLIA",
"last_name": "REDWAY",
"middle_name": "A",
"credential": "LCSW,MSW,BA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Torrington, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.