Nicholas Johnson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

255710 Issued in KY

Practice address

1312 Westen St
Bowling Green, KY 42104-3352

Phone

(270) 784-9630

Fax

(270) 904-1073

NPI assigned

Sep 9, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1536451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1235612946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 WESTEN ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421043352",
            "telephone_number": "270-904-1072",
            "fax_number": "270-904-1073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 WESTEN ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421043352",
            "telephone_number": "270-784-9630",
            "fax_number": "270-904-1073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NICHOLAS",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-09",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "255710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100753330",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "administration@wilsoncounselingllc.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "1312 Westen St",
            "city": "Bowling Green",
            "state": "KY",
            "country_code": "US",
            "postal_code": "421043352",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Juanita G Johnson, OT
• Lydia Johnson
• Matthew J Johnson, PT
• Michaela Dawn Johnson, APRN
• Nathan Layne Johnson
• Rhonda G. Johnson, LCSW
• Richard Matthew Johnson, SERVICE COORDINATOR
• Samantha Jo Johnson
• Sheridan Hope Johnson, MS CCC SLP
• Tori Johnson

• Clinical Social Worker in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Clinical Social Worker in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.