Active NPI
Gheislyn Layatta Johnson
- Social Worker
- Freeport, NY
National Provider Identifier
1487295655
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 070556
- Practice address
- 53 E Merrick Rd Unit 154
Freeport, NY 11520-4056 - Phone
- (516) 806-0833
- NPI assigned
- Sep 30, 2019
- Last updated
- Sep 30, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 | 070556 | NY | Primary |
Addresses
Primary practice location
53 E Merrick Rd Unit 154
Freeport, NY 11520-4056
Mailing address
53 E Merrick Rd Unit 154
Freeport, NY 11520-4056
Phone (516) 806-0833
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 |
|---|---|---|---|
| 070556 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569801600000",
"number": "1487295655",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "53 E MERRICK RD UNIT 154",
"city": "FREEPORT",
"state": "NY",
"postal_code": "115204056",
"telephone_number": "516-806-0833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "53 E MERRICK RD UNIT 154",
"city": "FREEPORT",
"state": "NY",
"postal_code": "115204056",
"telephone_number": "516-806-0833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "GHEISLYN",
"middle_name": "LAYATTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-30",
"last_updated": "2019-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "070556",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Freeport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.