Individual provider Active NPI

Tiffany Dianne Johnson, LCSW

  • Clinical Social Worker
  • Clarksville, IN
National Provider Identifier
1124442603
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34007645A Issued in IN
Practice address
757 E Lewis and Clark Pkwy # 2031
Clarksville, IN 47129-2269
Phone
(502) 536-8848
NPI assigned
Feb 5, 2014
Last updated
Aug 19, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 259524 KY
Clinical Social Worker 1041C0700X 0009920292 CO
Clinical Social Worker 1041C0700X 34007645A IN Primary

Addresses

Primary practice location

757 E Lewis and Clark Pkwy # 2031
Clarksville, IN 47129-2269

Mailing address

757 E Lewis and Clark Pkwy # 2031
Clarksville, IN 47129-2269
Phone (502) 536-8848

Other identifiers 4

IdentifierTypeStateIssuer
34007645AOtherINLCSW
1124442603OtherNPI
0009920292OtherCOLSW
259524OtherKYLCSW

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161109000879 IN Practitioner - Clinical Social Worker 9234418542 Reassigns benefits to 4 organizations
I20250903003814 KY Practitioner - Clinical Social Worker 9234418542 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians
Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

1919 State St
Suite 248
New Albany, IN 47150-6804
Phone (812) 542-4921

312 S 4TH St
Suite 700
Louisville, KY 40202-3046
Phone (866) 630-0966

333 N Alabama St
Suite 350
Indianapolis, IN 46204-2275
Phone (866) 630-0966

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0009920292COMDClinical Social Worker
34007645AINMDClinical Social Worker
259524KYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Clinical CurrentSince Jul 22, 2025 Accepting new patients
Baptist Health Medical Group Inc Current Accepting new patients
Lifespring, Inc CurrentSince Oct 8, 2016 Accepting new patients
Sondermind Provider Network LLC Clinical CurrentSince Aug 1, 2025 Accepting new patients
Baptist Health Medical Group Inc Clinical CurrentSince Feb 1, 2024 Accepting new patients
Lifespring, Inc CurrentSince Oct 8, 2016 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Feb 1, 2024 Accepting new patients
Healing Together Clinical Past Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

333 N Alabama St
Ste 350
Indianapolis, IN 46204
Phone (317) 983-0002

9465 Counselors Row
Ste 200
Indianapolis, IN 46240
Phone (463) 220-4646

1036 Sharon Dr
Jeffersonvlle, IN 47130
Phone (812) 258-9281

460 Spring St
Jeffersonvlle, IN 47130
Phone (812) 280-3583

1373 N State Road 62
Madison, IN 47250
Phone (812) 801-0196

1919 State St
Ste 248
New Albany, IN 47150
Phone (812) 945-7972

312 S 4th St
Ste 700
Louisville, KY 40202
Phone (502) 628-5023

5200 Commerce Crossings Dr
Fl 3
Louisville, KY 40229
Phone (502) 253-4924

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1391558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1124442603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "757 E LEWIS AND CLARK PKWY # 2031",
            "city": "CLARKSVILLE",
            "state": "IN",
            "postal_code": "471292269",
            "telephone_number": "502-536-8848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 E LEWIS AND CLARK PKWY # 2031",
            "city": "CLARKSVILLE",
            "state": "IN",
            "postal_code": "471292269",
            "telephone_number": "502-536-8848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TIFFANY",
        "middle_name": "DIANNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-05",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "259524",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "0009920292",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34007645A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "34007645A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1124442603",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LSW",
            "identifier": "0009920292",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "259524",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, IN

Sources for this page

Verify at the official NPI Registry.