Judith L Johnson, LCSW, LPC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW11715 Issued in FL

Practice address

104 Loyola Rd
St Augustine, FL 32086-6022

Phone

(573) 803-7892

Fax

(904) 797-2723

NPI assigned

Oct 3, 2006

Sex

Female

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Community Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cape Girardeau, MO
  • NPI 1235244757
  NPD (past)
• Community Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Cape Girardeau, MO
  • NPI 1861154130
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449014400000",
    "number": "1336234822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 LOYOLA RD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320866022",
            "telephone_number": "573-803-7892",
            "fax_number": "904-797-2723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 LOYOLA RD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320866022",
            "telephone_number": "573-803-7892",
            "fax_number": "904-797-2723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JUDITH",
        "middle_name": "L",
        "credential": "LCSW, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2015-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW11715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "493292817",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brianna Johnson
• Douglas L Johnson, DMD
• Edward Alan Johnson, PAC
• Erin Marie Johnson, LMT
• Grace Elizabeth Johnson
• Karen M Johnson
• Kerri Miranda Johnson, LM, CPM
• Lisa Ann Johnson, BA
• Marie Goretti Johnson
• Melissa Livia Devlin Johnson, LMT

• Clinical Social Worker in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2015; 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.