Individual provider Active NPI

Patricia R Johnson, QMHP

  • Clinical Social Worker
  • Milbank, SD
National Provider Identifier
1164413670
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1974 Issued in SD
Practice address
311 S Main St
Milbank, SD 57252-1810
Phone
(605) 660-0759
NPI assigned
Nov 3, 2005
Sex
Female
Sole proprietor
No

Organizations & group practices 3

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.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prairie Winds Counseling LLC (2 clinicians)

Practice addresses (Care Compare)

311 S Main St
Milbank, SD 57252-1810
Phone (605) 438-3333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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 records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20160219000848 SD Practitioner - Clinical Social Worker 7911096151 Reassigns benefits to 1 organization
Practice locations: Milbank, SD

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1974SDMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Prairie Winds Counseling, LLC Clinical CurrentSince Mar 1, 2020 Accepting new patients
Lewis & Clark Mental Health Center Past Accepting new patients
Lewis & Clark Behavioral Health Services, Inc. Social Worker Past Accepting new patients

Locations

311 S Main St
Milbank, SD 57252
Phone (605) 438-3333

102 W 4th Ave
Ste 1
Milbank, SD 57252
Phone (605) 660-0759

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 1974 SD
Clinical Social Worker 1041C0700X 1974 SD Primary

Addresses

NPPES NPI Registry

Primary practice location

311 S Main St
Milbank, SD 57252-1810

Mailing address

PO Box 386
Milbank, SD 57252-0386
Phone (605) 660-0759

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 5, 2023.

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1164413670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 386",
            "city": "MILBANK",
            "state": "SD",
            "postal_code": "572520386",
            "telephone_number": "605-660-0759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 S MAIN ST",
            "city": "MILBANK",
            "state": "SD",
            "postal_code": "572521810",
            "telephone_number": "605-660-0759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PATRICIA",
        "middle_name": "R",
        "credential": "QMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-03",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SD",
            "license": "1974",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SD",
            "license": "1974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milbank, SD

Sources for this page

Verify at the official NPI Registry.