Jennifer Twichell Johnson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW016079 Issued in PA

Practice address

1315 S Allen St Ste 102
State College, PA 16801-5923

Phone

(814) 308-9067

Fax

(814) 308-9073

NPI assigned

Nov 4, 2008

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1225756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604534400000",
    "number": "1164676151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1256 S GARNER ST",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168016326",
            "telephone_number": "814-954-4939",
            "fax_number": "814-308-9073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 S ALLEN ST STE 102",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168015923",
            "telephone_number": "814-308-9067",
            "fax_number": "814-308-9073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JENNIFER",
        "middle_name": "TWICHELL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-04",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW016079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "statecollegeroomtogrow@gmail.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "referral and general information",
            "address_1": "1315 S Allen St Ste 102",
            "city": "State College",
            "state": "PA",
            "country_code": "US",
            "postal_code": "168015923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer Lee Johannes, ATC
• John Roberts Enterprises Inc
• John W. Leclair DMD
• Nicole Ardell Johndrow, LSW
• Amanda Johnson
• Kimberly Johnson
• Matthew Ethan Johnson, PA-C
• McKenzie Rae Johnson, PA-C
• Bruce Dalton Johnston, R.PH.
• Christopher Roser Jones, M.D.

• Clinical Social Worker in State College, PA
• Providers in State College, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.