Jeffrey Robert Johnson, LCSW-R

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R041610 Issued in NY

Practice address

252 Ranch TRL W
3495 Bailey Avenue
Buffalo, NY 14221-2246

Phone

(716) 834-4270

NPI assigned

Jul 25, 2006

Sex

Male

Sole proprietor

Yes

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)

Enrolled

State licenses

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316960107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "252 RANCH TRL W",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142212246",
            "telephone_number": "716-689-4326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "252 RANCH TRL W",
            "address_2": "3495 BAILEY AVENUE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142212246",
            "telephone_number": "716-834-4270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JEFFREY",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R041610",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW-R",
            "identifier": "R041610",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dominique Johnson
• Emily Elizabeth Johnson, PA-C
• Eric Johnson
• Imari Johnson
• Jamie Lynn Johnson, M. ED
• Jennifer Lynn Johnson, MSW
• Kathleen Mary Johnson, FNP
• Keelyn Johnson
• Kerron Johnson
• Kimberly Johnson

• Clinical Social Worker in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.