Active NPI
Elicia Johnson
- Social Worker
- Dayton, OH
National Provider Identifier
1376185108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- S.1904205
- Practice address
- 1129 Miamisburg Centerville Rd
Dayton, OH 45449-4004 - Phone
- (937) 287-0953
- NPI assigned
- Oct 14, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | S.1904205 | OH | Primary |
Addresses
Primary practice location
1129 Miamisburg Centerville Rd
Dayton, OH 45449-4004
Mailing address
2213 Gipsy Dr
Dayton, OH 45414-3341
Phone (937) 287-0953
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S.1904205 | OH | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571011200000",
"number": "1376185108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2213 GIPSY DR",
"city": "DAYTON",
"state": "OH",
"postal_code": "454143341",
"telephone_number": "937-287-0953"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1129 MIAMISBURG CENTERVILLE RD",
"city": "DAYTON",
"state": "OH",
"postal_code": "454494004",
"telephone_number": "937-287-0953"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "ELICIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-10-14",
"last_updated": "2019-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "OH",
"license": "S.1904205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.