Individual provider Active NPI

Katherine Nicole Johnson, LMSW

  • Clinical Social Worker
  • Lewiston, ID
National Provider Identifier
1457964165
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8861806 Issued in ID
Practice address
1203 Idaho St
Lewiston, ID 83501-1940
Phone
(208) 848-8300
NPI assigned
Aug 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Social Worker 104100000X LMSW-41467 ID
Clinical Social Worker 1041C0700X 8861806 ID Primary
Social Worker 104100000X SC61133193 WA

Addresses

Primary practice location

1203 Idaho St
Lewiston, ID 83501-1940

Mailing address

611 N Iron Bridge Way
Spokane, WA 99202-4932
Phone (509) 444-8888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMSW-41467IDMDSocial Worker
SC61133193WAMDSocial Worker
8861806IDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph Hospital LLC CurrentSince Mar 15, 2025 Accepting new patients
Community Health Association of Spokane Social Worker CurrentSince Nov 5, 2024 Accepting new patients
Community Health Association of Spokane Current Accepting new patients
Community Health Association of Spokane CurrentSince Nov 5, 2024 Accepting new patients
Dragonfly Counseling PLLC Clinical PastSince Aug 1, 2020 Accepting new patients

Locations

821 21st Ave
Lewiston, ID 83501
Phone (208) 799-3422

1250 Idaho St
Lewiston, ID 83501
Phone (208) 743-7427

1203 Idaho St
Lewiston, ID 83501
Phone (208) 848-8300

803 S Main St
Ste 120
Moscow, ID 83843
Phone (208) 848-8300

1720 2nd St
Cheney, WA 99004
Phone (207) 865-8002

611 N Iron Bridge Way
Spokane, WA 99202

5921 N Market St
Spokane, WA 99208
Phone (509) 487-1604

3919 N Maple St
Spokane, WA 99205
Phone (509) 326-6900

914 W Carlisle Ave
Spokane, WA 99205
Phone (509) 325-0393

5620 S Regal St
Ste 11
Spokane, WA 99223
Phone (509) 340-1590

1001 W 2nd Ave
Spokane, WA 99201
Phone (509) 835-1205

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1598227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1457964165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 N IRON BRIDGE WAY",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992024932",
            "telephone_number": "509-444-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 IDAHO ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835011940",
            "telephone_number": "208-848-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KATHERINE",
        "middle_name": "NICOLE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-24",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LMSW-41467",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "8861806",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WA",
            "license": "SC61133193",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

Verify at the official NPI Registry.