Kizmet Johnson

Primary specialty

Social WorkerTaxonomy code 104100000X

License

PLMSW Issued in AR

Practice address

10600 Train Station Dr
Mabelvale, AR 72103-1644

Phone

(501) 753-8400

Fax

(501) 753-8401

NPI assigned

Jun 6, 2019

Last updated

Jun 6, 2019By the provider in NPPES

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

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

{
    "created_epoch": "1559779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559779200000",
    "number": "1356900146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "829 HALBERT ST",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721042607",
            "telephone_number": "501-332-4400",
            "fax_number": "501-332-4403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10600 TRAIN STATION DR",
            "city": "MABELVALE",
            "state": "AR",
            "postal_code": "721031644",
            "telephone_number": "501-753-8400",
            "fax_number": "501-753-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KIZMET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-06",
        "last_updated": "2019-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": "PLMSW",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cecelia Harris, M.A., CCC-SLP
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• Social Worker in Mabelvale, AR
• Providers in Mabelvale, AR by specialty
• Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2019; 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.