Individual provider Active NPI

Renee M Johnson, LCSW

  • Social Worker
  • Tucson, AZ
National Provider Identifier
1427064286
Registry record updated Aug 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LCSW-10145 Issued in AZ
Practice address
8478 E. Speedway Blvd
Suite 307
Tucson, AZ 85710-1730
Phone
(520) 981-6988
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LCSW-10145 AZ Primary

Addresses

Primary practice location

8478 E. Speedway Blvd
Suite 307
Tucson, AZ 85710-1730

Mailing address

8478 E. Speedway Blvd
Suite 307
Tucson, AZ 85710-1730
Phone (520) 981-6988

Other names 1

  • Renee M Stofko Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20091120000163 AZ Practitioner - Clinical Social Worker 0749329373 Practice locations: Tucson, AZ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

5210 E Pima St
Suite 200a
Tucson, AZ 85712-3678
Phone (520) 981-6988

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377129600000",
    "number": "1427064286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8478 E. SPEEDWAY BLVD",
            "address_2": "SUITE 307",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857101730",
            "telephone_number": "520-981-6988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8478 E. SPEEDWAY BLVD",
            "address_2": "SUITE 307",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857101730",
            "telephone_number": "520-981-6988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RENEE",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2013-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AZ",
            "license": "LCSW-10145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENEE",
            "last_name": "STOFKO",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.