Individual provider Active NPI

Michael Johnston, LCSW

  • Clinical Social Worker
  • Scarborough, ME
National Provider Identifier
1194374355
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC18231 Issued in ME
Practice address
20 Mussey Rd
Scarborough, ME 04074-9570
Phone
(207) 838-0512
NPI assigned
Sep 10, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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 LC18231 ME Primary

Addresses

Primary practice location

20 Mussey Rd
Scarborough, ME 04074-9570

Mailing address

20 Mussey Rd
Scarborough, ME 04074-9570
Phone (207) 200-5621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
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
I20211104003173 ME Practitioner - Clinical Social Worker 1850780263 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

20 Mussey Rd
Scarborough, ME 04074-9570
Phone (207) 200-5621

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC18231MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Maine Psychotherapy LLC Clinical CurrentSince Mar 1, 2024 Accepting new patients
Art of Awareness, Inc. Clinical CurrentSince Oct 13, 2021 Accepting new patients

Locations

20 Mussey Rd
Scarborough, ME 04074
Phone (207) 200-5621

100 Waterman Dr
Ste 201
South Portland, ME 04106
Phone (207) 613-4125

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1194374355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 MUSSEY RD",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749570",
            "telephone_number": "207-200-5621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 MUSSEY RD",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749570",
            "telephone_number": "207-838-0512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "MICHAEL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-10",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC18231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarborough, ME

Sources for this page

Verify at the official NPI Registry.