Active NPI
Doretha Johnson, LMSW
- Social Worker
- Jackson, TN
National Provider Identifier
1144645763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 8927
- Practice address
- 60 Lynoak CV
Jackson, TN 38305-2909 - Phone
- (731) 668-7593
- NPI assigned
- Feb 19, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 8927 | TN | Primary |
Addresses
Primary practice location
60 Lynoak CV
Jackson, TN 38305-2909
Mailing address
60 Lynoak CV
Jackson, TN 38305-2909
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20-3858944 | Other | TN | CHILD AND FAMILY THERAPIST |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8927 | TN | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1392768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1394064000000",
"number": "1144645763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 LYNOAK CV",
"city": "JACKSON",
"state": "TN",
"postal_code": "383052909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60 LYNOAK CV",
"city": "JACKSON",
"state": "TN",
"postal_code": "383052909",
"telephone_number": "731-668-7593"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "DORETHA",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-19",
"last_updated": "2014-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "TN",
"license": "8927",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHILD AND FAMILY THERAPIST",
"identifier": "20-3858944",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jackson, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.