Active NPI
Hilary Johnson, LLMSW
- Clinical Social Worker
- Ferndale, MI
National Provider Identifier
1174100960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6851105997
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230301001960 | MI | Practitioner - Clinical Social Worker | 8022481605 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6851105997 | MI | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairsky Foundation | Clinical | Current | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2021; 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.