Elizabeth Gail Johnson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7275 Issued in WI

Practice address

13380 W Trepania Rd
Hayward, WI 54843-2186

Phone

(715) 638-5100

Fax

(715) 634-6107

NPI assigned

Feb 27, 2007

Last updated

Apr 23, 2015By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2002

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Kettle Moraine Counseling LLCGroup PAC ID 8527353747, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Kettle Moraine Counseling LLC

  dba Kettle Moraine Counseling

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • West Bend, WI
  • NPI 1568790954
  Medicare reassignment Care Compare group NPD
• Affiliated Clinical Services Inc

  • Multi-Specialty Clinic/Center
  • West Bend, WI
  • NPI 1851473698
  NPD (past)
• Cedarburg Physical Therapy, Inc

  • Physical Therapy Clinic/Center
  • Cedarburg, WI
  • NPI 1225040926
  NPD (past)

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429747200000",
    "number": "1417084559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13380 W TREPANIA RD",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "548432186",
            "telephone_number": "715-638-5100",
            "fax_number": "715-634-6107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13380 W TREPANIA RD",
            "city": "HAYWARD",
            "state": "WI",
            "postal_code": "548432186",
            "telephone_number": "715-638-5100",
            "fax_number": "715-634-6107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ELIZABETH",
        "middle_name": "GAIL",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2015-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "14818",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennie Tess Jahn, NP
• James L January, PT
• Kirsten Louise January, PT
• Anna Christine Jaquith, LAC, LMT
• Elizabeth Anne Johnson, LPC
• Meghan Johnson
• Melinda L Johnson, LPC
• Sandra J Johnson, APNP
• Thomas W Jordan
• Julie Beth Kahl, MD

• Clinical Social Worker in Hayward, WI
• Providers in Hayward, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.