Individual provider Active NPI

Hilary Johnson, LLMSW

  • Clinical Social Worker
  • Ferndale, MI
National Provider Identifier
1174100960
Registry record updated Aug 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6851105997 Issued in MI
Practice address
23231 Woodward Ave
Ferndale, MI 48220-1361
Phone
(248) 581-8777
NPI assigned
Mar 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2021

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 6851105997 MI Primary

Addresses

Primary practice location

23231 Woodward Ave
Ferndale, MI 48220-1361

Mailing address

23231 Woodward Ave
Ferndale, MI 48220-1361
Phone (248) 581-8777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20230301001960 MI Practitioner - Clinical Social Worker 8022481605 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6851105997MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fairsky Foundation Clinical CurrentSince Jan 4, 2023 Accepting new patients

Locations

23231 Woodward Ave
Ferndale, MI 48220
Phone (248) 565-6556

2020 Raybrook St SE
Ste 203
Grand Rapids, MI 49546
Phone (616) 285-9600

Organizations & group practices 1

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": "1616716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629590400000",
    "number": "1174100960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23231 WOODWARD AVE",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482201361",
            "telephone_number": "248-581-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23231 WOODWARD AVE",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482201361",
            "telephone_number": "248-581-8777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "HILARY",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-26",
        "last_updated": "2021-08-22",
        "certification_date": "2021-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6851105997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ferndale, MI

Sources for this page

Verify at the official NPI Registry.