Active NPI
Lydia Johnson, LICSW
- Social Worker
- Boston, MA
National Provider Identifier
1447727276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 215063
- Practice address
- 660 Harrison Ave
Boston, MA 02118-2304 - Phone
- (617) 859-7000
- Fax
- (617) 262-2089
- NPI assigned
- Oct 30, 2018
- Sex
- Female
- Sole proprietor
- No
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 | 215063 | MA | Primary |
Addresses
Primary practice location
660 Harrison Ave
Boston, MA 02118-2304
Mailing address
660 Harrison Ave
Boston, MA 02118-2304
Phone (617) 859-7000
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 |
|---|---|---|---|
| 215063 | MA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686787200000",
"number": "1447727276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "660 HARRISON AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182304",
"telephone_number": "617-859-7000",
"fax_number": "617-262-2089"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "660 HARRISON AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182304",
"telephone_number": "617-859-7000",
"fax_number": "617-262-2089"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "LYDIA",
"name_prefix": "Ms.",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-30",
"last_updated": "2023-06-15",
"certification_date": "2023-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MA",
"license": "215063",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.