Individual provider Active NPI

Kaitlind Elizabeth Johnson, LCSW

  • Clinical Social Worker
  • Reno, NV
National Provider Identifier
1043856198
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8709-C Issued in NV
Practice address
580 W 5TH St
Reno, NV 89503-4407
Phone
(775) 786-4673
Fax
(775) 326-2958
NPI assigned
Nov 25, 2019
Last updated
Oct 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 8709-C NV Primary

Addresses

Primary practice location

580 W 5TH St
Reno, NV 89503-4407

Mailing address

580 W 5TH St
Reno, NV 89503-4407
Phone (775) 786-4673

Other practice location 1

458 Court St Ste 106
Reno, NV 89501-1709
Phone (775) 453-6841

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kbecker@nnhopes.org Direct
Direct Messaging Address k.johnson775@outlook.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20200810001391 NV Practitioner - Clinical Social Worker 0941625271 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8709-CNVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Gentry Integrated Sleep and Wellness PLLC CurrentSince Jul 11, 2020 Accepting new patients
Headway California Behavioral Health Services, P.C. CurrentSince Dec 20, 2024 Accepting new patients
Flourish Nevada Counseling and Wellness PLLC Clinical CurrentSince Jun 4, 2023 Accepting new patients
Northern Nevada HIV Outpatient Program, Education and Services CurrentSince Nov 16, 2020 Accepting new patients
Northern Nevada HIV Outpatient Program, Education and Services CurrentSince Nov 16, 2020 Accepting new patients

Locations

2300 W Sahara Ave
Ste 800
Las Vegas, NV 89102
Phone (702) 234-3311

10631 Professional Cir
Ste A
Reno, NV 89521
Phone (775) 826-6218

458 Court St
Ste 106
Reno, NV 89501
Phone (775) 453-6841

580 W 5th St
Reno, NV 89503
Phone (775) 786-4673

205 Hudson St
Fl 9
New York, NY 10013
Phone (516) 274-9095

Interoperability endpoints

  • Direct secure messaging: kaitlind.becker@nnhopes.eclinicaldirectplus.com

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1574640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1043856198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 W 5TH ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895034407",
            "telephone_number": "775-786-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 W 5TH ST",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895034407",
            "telephone_number": "775-786-4673",
            "fax_number": "775-326-2958"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "458 Court St Ste 106",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895011709",
            "country_code": "US",
            "telephone_number": "775-453-6841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KAITLIND",
        "middle_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-25",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "8709-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbecker@nnhopes.org",
            "affiliation": "N",
            "endpointDescription": "Business Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct",
            "address_1": "580 W 5th St",
            "city": "Reno",
            "state": "NV",
            "country_code": "US",
            "postal_code": "895034407",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "k.johnson775@outlook.com",
            "affiliation": "N",
            "endpointDescription": "Business Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct",
            "address_1": "458 Court St Ste 106",
            "city": "Reno",
            "state": "NV",
            "country_code": "US",
            "postal_code": "895011709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.