Andra Caven Johnson, LSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

S.0032144 Issued in OH

Practice address

3958 Brown Park Dr Ste D
Hilliard, OH 43026-1160

Phone

(510) 201-0190

Fax

(888) 972-2903

NPI assigned

Sep 13, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1536796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1174006266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3675 E 140TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441204548",
            "telephone_number": "216-632-3022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3958 BROWN PARK DR STE D",
            "city": "HILLIARD",
            "state": "OH",
            "postal_code": "430261160",
            "telephone_number": "510-201-0190",
            "fax_number": "888-972-2903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANDRA",
        "middle_name": "CAVEN",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-09-13",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S.0032144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "S0032144",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• JJR Capital Group LLC
• John a. Ritchie D.D.S., Inc.
• Ronald Johnsen, DO
• Kimberly C Johnson-Smith, LISW-S
• Acacia La Dawn Johnson
• Emily Johnson
• Eric Alan Johnson, PT, DPT
• Grace O'Brien Johnson, PA-C
• Janee Johnson
• Julie M. Johnson, M.A. CCC/SLP

• Social Worker in Hilliard, OH
• Providers in Hilliard, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; 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.