Brooke Larson Johnson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW007117 Issued in GA

Practice address

738 Woodlawn Drive
Marietta, GA 30068

Phone

(770) 726-9589

NPI assigned

Sep 4, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Brooke Erin Larson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 13, 2024 through Mar 13, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Art It Out Therapy Center

  • Community/Behavioral Health Agency
  • Marietta, GA
  • NPI 1508216615
  NPD (past)

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

{
    "created_epoch": "1567555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698105600000",
    "number": "1447809355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2875 BARBARA LANE NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30062",
            "telephone_number": "770-726-9589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "738 WOODLAWN DRIVE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "30068",
            "telephone_number": "770-726-9589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BROOKE",
        "middle_name": "LARSON",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-04",
        "last_updated": "2023-10-24",
        "certification_date": "2022-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW007117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROOKE",
            "last_name": "LARSON",
            "middle_name": "ERIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Christine Johnon, PHARMD
• Sarah Gardiner Johns, MS, ATR-BC, LPC
• Johnson Ferry Dentistry, PC
• Alisha Sharvae Johnson
• Aric Johnson
• Carlos Johnson
• Carol Johnson, PT
• Carolyn N. Johnson, PH.D.
• Courtney Johnson, LPC
• Craig G. Johnson, MD

• Clinical Social Worker in Marietta, GA
• Providers in Marietta, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.