Individual provider Active NPI

Christine M Johannesson, M.S.W., L.C.S.W.

  • Clinical Social Worker
  • Norristown, PA
National Provider Identifier
1073668372
Registry record updated Dec 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW124279 Issued in PA
Practice address
1201 Dekalb St
Norristown, PA 19401-3415
Phone
(610) 279-9270
Fax
(610) 279-4146
NPI assigned
Jan 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2009

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 SW124279 PA Primary

Addresses

Primary practice location

1201 Dekalb St
Norristown, PA 19401-3415

Mailing address

1201 Dekalb St
Norristown, PA 19401-3415
Phone (610) 279-9270

Other names 1

  • Christine M Johannesson Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20071008000472 PA Practitioner - Clinical Social Worker 5799870598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Central Behavioral HealthGroup PAC ID 0941109730, 31 clinicians

Practice addresses (Care Compare)

1201 Dekalb St
Norristown, PA 19401-3415
Phone (610) 277-4600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW124279PAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Central Behavioral Health CurrentSince Aug 16, 2007 Accepting new patients

Locations

1201 DeKalb St
Norristown, PA 19401
Phone (610) 277-4600

1100 Powell St
Norristown, PA 19401
Phone (484) 806-2012

Organizations & group practices 1

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261353600000",
    "number": "1073668372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 DEKALB ST",
            "city": "NORRISTOWN",
            "state": "PA",
            "postal_code": "194013415",
            "telephone_number": "610-279-9270",
            "fax_number": "610-279-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 DEKALB ST",
            "city": "NORRISTOWN",
            "state": "PA",
            "postal_code": "194013415",
            "telephone_number": "610-279-9270",
            "fax_number": "610-279-4146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANNESSON",
        "first_name": "CHRISTINE",
        "middle_name": "M",
        "credential": "M.S.W., L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2009-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "SW124279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "JOHANNESSON",
            "middle_name": "M",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Norristown, PA

Sources for this page

Verify at the official NPI Registry.