Cynthia Lynn Johnson, LCSW LICENESED CLINI

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LSW0000004454 Issued in TN

Practice address

106 Ash St
Adamsville, TN 38310-4961

Phone

(731) 315-1213

Fax

(731) 315-1213

NPI assigned

Jan 23, 2007

Last updated

Dec 30, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Cynthia Lynn Smith Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1083768345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 61",
            "city": "ADAMSVILLE",
            "state": "TN",
            "postal_code": "383100061",
            "telephone_number": "731-315-1213",
            "fax_number": "731-315-1213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 ASH ST",
            "city": "ADAMSVILLE",
            "state": "TN",
            "postal_code": "383104961",
            "telephone_number": "731-315-1213",
            "fax_number": "731-315-1213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CYNTHIA",
        "middle_name": "LYNN",
        "credential": "LCSW LICENESED CLINI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "LSW0000004454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CYNTHIA",
            "last_name": "SMITH",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• John Timothy Johnson, RPH.
• Raven Kelley
• Elizabeth Ann Kelly, ASSISTANT
• Monica Kimmons
• Stephanie Lauren Long

• Clinical Social Worker in Adamsville, TN
• Providers in Adamsville, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2021; 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.