Individual provider Active NPI

Shannon Cochrance Johnson, LCSW

  • Clinical Social Worker
  • Lexington, KY
National Provider Identifier
1174655237
Registry record updated Oct 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3572 Issued in KY
Practice address
2250 Thunderstick Dr Ste 1104
Lexington, KY 40505-9009
Phone
(859) 254-1035
Fax
(859) 254-2075
NPI assigned
Mar 12, 2007
Last updated
Oct 2, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 3572 KY
Clinical Social Worker 1041C0700X 3572 KY Primary

Addresses

Primary practice location

2250 Thunderstick Dr Ste 1104
Lexington, KY 40505-9009

Mailing address

2250 Thunderstick Dr Ste 1104
Lexington, KY 40505-9009
Phone (859) 254-1035

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20130828000904 KY Practitioner - Clinical Social Worker 9436392164 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3572KYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
KVC Behavioral Healthcare Kentucky Inc Clinical CurrentSince May 15, 2021 Accepting new patients
Psychological & Behavioral Consultants, LLC Clinical CurrentSince Jun 1, 2021 Accepting new patients

Locations

649 Chamberlin Ave
Frankfort, KY 40601
Phone (502) 875-1685

2250 Thunderstick Dr
Ste 1104
Lexington, KY 40505
Phone (859) 436-1059

100 Executive Park
Ste 103
Louisville, KY 40207
Phone (502) 552-5068

25101 Chagrin Blvd
Ste 100
Beachwood, OH 44122
Phone (216) 245-4468

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1174655237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 THUNDERSTICK DR STE 1104",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405059009",
            "telephone_number": "859-254-1035",
            "fax_number": "859-254-2075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2250 THUNDERSTICK DR STE 1104",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405059009",
            "telephone_number": "859-254-1035",
            "fax_number": "859-254-2075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SHANNON",
        "middle_name": "COCHRANCE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KY",
            "license": "3572",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "3572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.