Alysa Harless Johnson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

77484 Issued in CA

Practice address

14011 Lodgepole CT
Penn Valley, CA 95946-9128

Phone

(906) 407-0047

Fax

(916) 405-4002

NPI assigned

Mar 18, 2016

Last updated

Mar 9, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Alysa Harless Former name

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Clinical Social Worker

Education

Other, 2012

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Therapy Link, Licensed Clinical Social Worker, Inc.

  dba Therapy Link

  • Clinical Social Worker
  • Penn Valley, CA
  • NPI 1629726328
  NPD Authorized official
• Sondermind Professional Clinical Counselor, PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1598629362
  Medicare reassignment
• Center for New Directions, Inc.

  • Mental Health Counselor
  • Laguna Hills, CA
  • NPI 1578121190
  NPD (past)

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

{
    "created_epoch": "1458259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646784000000",
    "number": "1235590258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11354 PLEASANT VALLEY RD # 94",
            "city": "PENN VALLEY",
            "state": "CA",
            "postal_code": "959469000",
            "telephone_number": "906-407-0047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14011 LODGEPOLE CT",
            "city": "PENN VALLEY",
            "state": "CA",
            "postal_code": "959469128",
            "telephone_number": "906-407-0047",
            "fax_number": "916-405-4002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Prison Rd",
            "address_purpose": "LOCATION",
            "city": "Represa",
            "state": "CA",
            "postal_code": "956713000",
            "country_code": "US",
            "telephone_number": "916-985-8610 x6260",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15301 Warren Shingle Rd",
            "address_purpose": "LOCATION",
            "city": "Beale AFB",
            "state": "CA",
            "postal_code": "959031907",
            "country_code": "US",
            "telephone_number": "530-634-4662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ALYSA",
        "middle_name": "HARLESS",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-18",
        "last_updated": "2022-03-09",
        "certification_date": "2022-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "77484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSA",
            "last_name": "HARLESS",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hass & Nour LLC (Pleasant Valley Pharmacy)
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• Patricia Hastert, DC
• Elizabeth Ann Hatfield-Howe
• Kimberly Hoover, LAC
• Leclair Fitness VI, LLC
• Clifford James Leduc, P.T.
• Pamela Andrea Leduc, P.T.
• Karen D Lee, NP
• Elisabeth Lernhardt, MD

• Clinical Social Worker in Penn Valley, CA
• Providers in Penn Valley, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.