Individual provider Active NPI

Hiram K Johnson, MA, LCSW

  • Clinical Social Worker
  • Fairhope, AL
National Provider Identifier
1154467306
Registry record updated Feb 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3241142C Issued in AL
Practice address
22765 US Highway 98 Ste A4
Fairhope, AL 36532-3501
Phone
(251) 517-7585
Fax
(251) 929-4217
NPI assigned
Jan 29, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3241142C AL Primary

Addresses

Primary practice location

22765 US Highway 98 Ste A4
Fairhope, AL 36532-3501

Mailing address

22765 US Highway 98 Ste A4
Fairhope, AL 36532-3501
Phone (251) 517-7585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20091023000590 AL Practitioner - Clinical Social Worker 6002953023 Practice locations: Fairhope, AL

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

22765 US Hwy 98
Unit a 4
Fairhope, AL 36532-3499
Phone (251) 802-7466

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
3241142CALMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Mental Health Services PC Past Accepting new patients
Coastal Counseling and Consulting, LLC Clinical Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677283200000",
    "number": "1154467306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22765 US HIGHWAY 98 STE A4",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365323501",
            "telephone_number": "251-517-7585",
            "fax_number": "251-929-4217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22765 US HIGHWAY 98 STE A4",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365323501",
            "telephone_number": "251-517-7585",
            "fax_number": "251-929-4217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "HIRAM",
        "middle_name": "K",
        "name_prefix": "Mr.",
        "credential": "MA, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2023-02-25",
        "certification_date": "2023-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "3241142C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairhope, AL

Sources for this page

Verify at the official NPI Registry.