Individual provider Active NPI

Jane E Johnson, LCSW

  • Clinical Social Worker
  • Tuscon, AZ
National Provider Identifier
1487718813
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW0556 Issued in AZ
Practice address
2238 E Ginter Road
Sunnyside Unified School District No 12
Tuscon, AZ 95706
Phone
(520) 545-2137
Fax
(520) 545-2120
NPI assigned
Dec 20, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW0556 AZ Primary

Addresses

Primary practice location

2238 E Ginter Road
Sunnyside Unified School District No 12
Tuscon, AZ 95706

Mailing address

2238 E Ginter Road
Sunnyside Unified School District No 12
Tuscon, AZ 95706
Phone (520) 545-2137

Other identifiers 1

IdentifierTypeStateIssuer
583957MedicaidAZ

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
I20250303002625 AZ Practitioner - Clinical Social Worker 5799206090 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW0556AZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Clinical Current Accepting new patients
Mental Health Specialty Group PA CurrentSince Feb 1, 2025 Accepting new patients

Locations

2550 W Union Hills Dr
Phoenix, AZ 85027
Phone (602) 358-0224

Interoperability endpoints

  • Direct secure messaging: janemiclon@tdh.allscriptsdirect.net

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1487718813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2238 E GINTER ROAD",
            "address_2": "SUNNYSIDE UNIFIED SCHOOL DISTRICT NO 12",
            "city": "TUSCON",
            "state": "AZ",
            "postal_code": "95706",
            "telephone_number": "520-545-2137",
            "fax_number": "520-545-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2238 E GINTER ROAD",
            "address_2": "SUNNYSIDE UNIFIED SCHOOL DISTRICT NO 12",
            "city": "TUSCON",
            "state": "AZ",
            "postal_code": "95706",
            "telephone_number": "520-545-2137",
            "fax_number": "520-545-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JANE",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW0556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "583957",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscon, AZ

Sources for this page

Verify at the official NPI Registry.