Roberta Johnson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC11261 Issued in ME

Practice address

204 Water St
Ellsworth, ME 04605-2038

Phone

(207) 667-2061

NPI assigned

Nov 16, 2007

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

Medicare fee-for-service enrollment

Enrolled in ME

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

Specialty

Clinical Social Worker

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Health Affiliates Maine, LLCGroup PAC ID 1951594076, 169 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Health Affiliates Maine, LLC

  • Community/Behavioral Health Agency
  • Auburn, ME
  • NPI 1932413556
  Medicare reassignment Care Compare group NPD
• Possibilities Counseling Services

  • Community/Behavioral Health Agency
  • Auburn, ME
  • NPI 1871805507
  NPD (past)
• Possibilities Counseling Services Inc.

  • Community/Behavioral Health Agency
  • Auburn, ME
  • NPI 1235461716
  NPD (past)

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

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195171200000",
    "number": "1104007236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 NEILS COVE LN",
            "city": "STONINGTON",
            "state": "ME",
            "postal_code": "046813034",
            "telephone_number": "207-367-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 WATER ST",
            "city": "ELLSWORTH",
            "state": "ME",
            "postal_code": "046052038",
            "telephone_number": "207-667-2061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ROBERTA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-16",
        "last_updated": "2007-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC11261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dylan Patrick Jacobus, M.D.
• Jane Garfield Dba Mednow Clinic Ellsworth
• David Alvin Jardine, AU.D.
• Elizabeth Beal Jardine, AU.D.
• Bethany L. Jarvis, FNP
• Judith Mae Jones
• Gopinatha Albert Joseph, DO
• Amy Jourdet
• Lisa Tymeson Jung, LCSW
• Peter W Just, MD

• Clinical Social Worker in Ellsworth, ME
• Providers in Ellsworth, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.