Kyndra Joy Johnson, LISW-CP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15329 Issued in SC

Practice address

421 W Boyce St
Manning, SC 29102-2615

Phone

(803) 696-4195

NPI assigned

Jan 10, 2023

Last updated

Jan 10, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1673308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673308800000",
    "number": "1164136594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 DRAYTON ST",
            "city": "MANNING",
            "state": "SC",
            "postal_code": "291022514",
            "telephone_number": "803-410-0781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 W BOYCE ST",
            "city": "MANNING",
            "state": "SC",
            "postal_code": "291022615",
            "telephone_number": "803-696-4195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KYNDRA",
        "middle_name": "JOY",
        "credential": "LISW-CP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-10",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "15329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Marie Hunt, O.D.
• Courtney Ives, BSN, RN, LNC
• J-Rapha Clinic LLC
• Matthew Richard Jackson, DO
• Adri Johnson
• Susanne P Johnson, FNP
• Cornelia Bradham Jones, APRN
• George R Jones, M.D.
• Shavonda Denise Jordan, MSW, PLCSW,LCASA
• Christopher Scott Joyner, PHARMD

• Clinical Social Worker in Manning, SC
• Providers in Manning, SC by specialty
• Clinical Social Worker in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.