Individual provider Active NPI

Ashley Pauline Johnson, LMSW

  • Clinical Social Worker
  • Southgate, MI
National Provider Identifier
1073098919
Registry record updated Jun 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801109993 Issued in MI
Practice address
13305 Reeck CT
Southgate, MI 48195
Phone
(734) 225-2090
NPI assigned
Sep 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2021

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 6801109993 MI Primary
Clinical Social Worker 1041C0700X 6801102587 MI

Addresses

Primary practice location

13305 Reeck CT
Southgate, MI 48195

Mailing address

6549 Town Center Dr Ste a
Clarkston, MI 48346-4824
Phone (248) 620-6400

Other practice location 1

8637 Bliss St
Detroit, MI 48234-3349
Phone (313) 329-8479

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20210730000551 MI Practitioner - Clinical Social Worker 9537562350 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Western Michigan Un Homer Stryker School of Med, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ismail B Sendi MD PCGroup PAC ID 4688674534, 72 clinicians
Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

13305 Reeck CT
Southgate, MI 48195-3197
Phone (800) 395-3223

3200 Greenfield Rd
Suite 109
Dearborn, MI 48120-1802
Phone (517) 492-0517

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801102587MIMDClinical Social Worker
6801109993MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ismail B. Sendi, MD, PC CurrentSince May 28, 2021 Accepting new patients
Ismail B. Sendi, MD, PC CurrentSince May 28, 2021 Accepting new patients
Richard Kneip, PH.D., P.C. Past Accepting new patients

Locations

6549 Town Center Dr
Ste A
Clarkston, MI 48346
Phone (248) 620-6400

13305 Reeck Ct
Southgate, MI 48195
Phone (734) 225-2090

Organizations & group practices 4

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": "1537920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1073098919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6549 TOWN CENTER DR STE A",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483464824",
            "telephone_number": "248-620-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13305 REECK CT",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "48195",
            "telephone_number": "734-225-2090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8637 Bliss St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482343349",
            "country_code": "US",
            "telephone_number": "313-329-8479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ASHLEY",
        "middle_name": "PAULINE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-26",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801109993",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801102587",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southgate, MI

Sources for this page

Verify at the official NPI Registry.