Mary Johnson, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

213448 Issued in MA

Practice address

31 Harvard St
Worcester, MA 01609-2836

Phone

(508) 756-4646

Fax

(508) 791-4755

NPI assigned

Sep 12, 2006

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Family Services Organization of Worcester, Inc

  dba Family Services of Central Massachusetts

  • Mental Health Counselor
  • Worcester, MA
  • NPI 1467556928
  NPD (past)

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184198400000",
    "number": "1316041940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 HARVARD ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016092836",
            "telephone_number": "508-756-4646",
            "fax_number": "508-791-4755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 HARVARD ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016092836",
            "telephone_number": "508-756-4646",
            "fax_number": "508-791-4755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-12",
        "last_updated": "2007-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "213448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON / BEACON",
            "identifier": "1030980",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda Marie Johnson, MD
• Mario Joseph Johnson
• Mark Johnson, MD
• Mark D Johnson, MD PHD
• Marques Amir Johnson, MD
• Mary Theresa Johnson, M.A.
• Maya Johnson
• Michelle Johnson
• Michelle Marie Johnson, MSW INTERN
• Neve Johnson

• Mental Health Counselor in Worcester, MA
• Providers in Worcester, MA by specialty
• Mental Health Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; 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.