Active NPI
Kirsten Ola Johannsen, LGSW
- Clinical Social Worker
- Rosedale, MD
National Provider Identifier
1174872691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 17357
- Practice address
- 8967 Yellow Brick Rd
Suite a
Rosedale, MD 21237-2303 - Phone
- (410) 780-4320
- NPI assigned
- Aug 29, 2012
- 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 | 17357 | MD | Primary |
Addresses
Primary practice location
8967 Yellow Brick Rd
Suite a
Rosedale, MD 21237-2303
Mailing address
8967 Yellow Brick Rd
Rosedale, MD 21237-2303
Phone (410) 780-4320
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17357 | MD | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346198400000",
"number": "1174872691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8967 YELLOW BRICK RD",
"city": "ROSEDALE",
"state": "MD",
"postal_code": "212372303",
"telephone_number": "410-780-4320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8967 YELLOW BRICK RD",
"address_2": "SUITE A",
"city": "ROSEDALE",
"state": "MD",
"postal_code": "212372303",
"telephone_number": "410-780-4320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHANNSEN",
"first_name": "KIRSTEN",
"middle_name": "OLA",
"credential": "LGSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-29",
"last_updated": "2012-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "17357",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rosedale, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.