Johanna Katheryne Smith Bakken, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1564 Issued in CO

Practice address

4891 Independence St
Suite 165
Wheat Ridge, CO 80033-6752

Phone

(303) 456-0600

Fax

(303) 456-0607

NPI assigned

Aug 19, 2008

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273708800000",
    "number": "1326295692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4891 INDEPENDENCE ST",
            "address_2": "SUITE 165",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336752",
            "telephone_number": "303-456-0600",
            "fax_number": "303-456-0607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4891 INDEPENDENCE ST",
            "address_2": "SUITE 165",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "800336752",
            "telephone_number": "303-456-0600",
            "fax_number": "303-456-0607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH BAKKEN",
        "first_name": "JOHANNA",
        "middle_name": "KATHERYNE",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-19",
        "last_updated": "2010-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "1564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kari E. Sloboth, PHARMD
• Katherine Elizabeth Slone, N.P.
• Cassie Lee Smartt, LCSW
• Smi Imaging LLC
• Smile Dental PC
• Margaret Smith-McEachern, MSW
• Brett Allen Smith
• Brielle Smith, PA-C
• Chelsea Smith, NP
• Destiny Smith

• Clinical Social Worker in Wheat Ridge, CO
• Providers in Wheat Ridge, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2010; 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.