Pernilla L Johansson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L3060 Issued in OR

Practice address

5460 Brownings Corners Rd
Florence, OR 97439-8849

Phone

(541) 305-5804

NPI assigned

Jul 10, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

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, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Roseburg Therapy LLC

  • Mental Health Counselor
  • Roseburg, OR
  • NPI 1538665013

  Clinical

  Medicare reassignment NPD
• Peacehealth

  dba Peace Harbor Medical Center

  • Critical Access Hospital
  • Florence, OR
  • NPI 1578552402
  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595548800000",
    "number": "1114951159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5460 BROWNINGS CORNERS RD",
            "city": "FLORENCE",
            "state": "OR",
            "postal_code": "974398849",
            "telephone_number": "541-305-5804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5460 BROWNINGS CORNERS RD",
            "city": "FLORENCE",
            "state": "OR",
            "postal_code": "974398849",
            "telephone_number": "541-305-5804"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1525 12th St Ste 22",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "OR",
            "postal_code": "974398487",
            "country_code": "US",
            "telephone_number": "541-902-0408",
            "fax_number": "541-902-7533",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1890 Waite St Ste 1",
            "address_purpose": "LOCATION",
            "city": "North Bend",
            "state": "OR",
            "postal_code": "974591229",
            "country_code": "US",
            "telephone_number": "541-435-7033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHANSSON",
        "first_name": "PERNILLA",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "3060",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L3060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292270",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "L3060",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "pennyjo2020@yahoo.com",
            "affiliation": "N",
            "address_1": "5460 Brownings Corners Rd",
            "city": "Florence",
            "state": "OR",
            "country_code": "US",
            "postal_code": "974398849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• William Mark Immel, N.D.
• Infinity Anesthesia LLC (Frequency Healing)
• Fadi I Jabr, M.D.
• Robert Leonard Jacques, M.D.
• Ian Mitchell Jarman, D.C.
• Sandra Jean Jones, FNP-BC
• Tze Yu Juang, PHARM D
• Denise Marie Kennedy Womack
• Stephen Samuel Kerner, D.O.
• Karly Laura Kerod, PT, DPT

• Clinical Social Worker in Florence, OR
• Providers in Florence, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; 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.