Active NPI
Wanda Johnson, LCSW
- Clinical Social Worker
- Rockland, ME
National Provider Identifier
1134305501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LC9867
- Practice address
- 91 Camden Street
Suite 206
Rockland, ME 04841 - Phone
- (207) 594-6699
- NPI assigned
- Jan 16, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC9867 | ME | Primary |
Addresses
Primary practice location
91 Camden Street
Suite 206
Rockland, ME 04841
Mailing address
91 Camden Street
Suite 206
Rockland, ME 04841
Phone (207) 594-6699
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LC9867 | ME | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351209600000",
"number": "1134305501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "91 CAMDEN STREET",
"address_2": "SUITE 206",
"city": "ROCKLAND",
"state": "ME",
"postal_code": "04841",
"telephone_number": "207-594-6699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "91 CAMDEN STREET",
"address_2": "SUITE 206",
"city": "ROCKLAND",
"state": "ME",
"postal_code": "04841",
"telephone_number": "207-594-6699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "WANDA",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-16",
"last_updated": "2012-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "LC9867",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.