Organization Active NPI

Drew M. Johnson LCSW LLC

  • Community/Behavioral Health Agency
  • Maplewood, NJ
National Provider Identifier
1184866824
Registry record updated Apr 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
44SC05288400 Issued in NJ
Legal business name
DREW M. JOHNSON LCSW LLC
Practice address
2130 Millburn Ave Ste D1
Maplewood, NJ 07040-3749
Phone
(973) 763-8123
Fax
(973) 763-8243
NPI assigned
Mar 26, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2009

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

Authorized official

Name
Mr. Drew McNeill Johnson, MSWNPI 1447430798
Title
Therapist
Phone
(917) 568-7524

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 44SC05288400 NJ Primary

Addresses

Primary practice location

2130 Millburn Ave Ste D1
Maplewood, NJ 07040-3749

Mailing address

94 Midland Blvd
Maplewood, NJ 07040-1810
Phone (917) 568-7524

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090408000027 NJ Part B Supplier - Clinic/Group Practice 9638226780 Receives reassigned benefits from 1 practitioner
Practice locations: Maplewood, NJ

National Provider Directory

National Provider Directory

Locations

2115 Millburn Ave
Ste 100
Maplewood, NJ 07040
Phone (973) 704-9589

169 Maplewood Ave
Ste 3
Maplewood, NJ 07040
Phone (917) 568-7524

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1238025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240185600000",
    "number": "1184866824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 MIDLAND BLVD",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070401810",
            "telephone_number": "917-568-7524",
            "fax_number": "973-763-8243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2130 MILLBURN AVE STE D1",
            "city": "MAPLEWOOD",
            "state": "NJ",
            "postal_code": "070403749",
            "telephone_number": "973-763-8123",
            "fax_number": "973-763-8243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DREW M. JOHNSON LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-26",
        "last_updated": "2009-04-20",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DREW",
        "authorized_official_middle_name": "MCNEILL",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "917-568-7524",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NJ",
            "license": "44SC05288400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.