Individual provider Active NPI

Christina Johnson Purcell, LCSW-C

  • Social Worker
  • Snow Hill, MD
National Provider Identifier
1053458661
Registry record updated May 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
16323 Issued in MD
Practice address
6040 Public Landing Rd.
Snow Hill, MD 21863-2453
Phone
(410) 632-1100
Fax
(410) 632-5682
NPI assigned
Jan 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X G11793 MD
Social Worker 104100000X 16323 MD Primary

Addresses

Primary practice location

6040 Public Landing Rd.
Snow Hill, MD 21863-2453

Mailing address

6040 Public Landing Road
Snow Hill, MD 21863-2453
Phone (410) 632-1100

Other identifiers 1

IdentifierTypeStateIssuer
705371101MedicaidMD

Other names 1

  • Christina Johnson Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
G11793MDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337212800000",
    "number": "1053458661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6040 PUBLIC LANDING ROAD",
            "city": "SNOW HILL",
            "state": "MD",
            "postal_code": "218632453",
            "telephone_number": "410-632-1100",
            "fax_number": "410-632-5682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6040 PUBLIC LANDING RD.",
            "city": "SNOW HILL",
            "state": "MD",
            "postal_code": "218632453",
            "telephone_number": "410-632-1100",
            "fax_number": "410-632-5682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURCELL",
        "first_name": "CHRISTINA",
        "middle_name": "JOHNSON",
        "name_prefix": "Mrs.",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2012-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "G11793",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "16323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "705371101",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "JOHNSON",
            "credential": "LCSW-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Snow Hill, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.