Kendra V Johnson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34008781A Issued in IN

Practice address

3520 Washington Blvd
Indianapolis, IN 46205-3719

Phone

(317) 343-8355

NPI assigned

Apr 12, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1586649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586649600000",
    "number": "1235758087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 ILLINOIS RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468041208",
            "telephone_number": "866-710-7129",
            "fax_number": "800-886-7248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 WASHINGTON BLVD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462053719",
            "telephone_number": "317-343-8355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KENDRA",
        "middle_name": "V",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-12",
        "last_updated": "2020-04-12",
        "certification_date": "2020-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34008781A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Johnson, RBT
• Kaylee Johnson
• Kelly Johnson, RBT
• Kelly Denise Johnson, FNP-C
• Kelsey Johnson
• Kenneth Clark Johnson, P.T.
• Khalilia Johnson
• Kim Johnson, MHR, D.MIN, CSAYC
• Kimberly Johnson, LMHCA
• Kimberly Diana Johnson, N.P.

• Clinical Social Worker in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.