Individual provider Active NPI

Andrea Moore Johnson

  • Clinical Social Worker
  • Brookline, MA
National Provider Identifier
1548233240
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
103118 Issued in MA
Practice address
43 Garrison Rd
Brookline, MA 02445-4445
Phone
(617) 277-8107
NPI assigned
Feb 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 103118 MA Primary

Addresses

Primary practice location

43 Garrison Rd
Brookline, MA 02445-4445

Mailing address

43 Garrison Rd
Brookline, MA 02445-4445
Phone (617) 277-8107

Other identifiers 1

IdentifierTypeStateIssuer
P10297OtherMABLUE CROSS/BLUESHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Sep 29, 2024 through Sep 29, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1139702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1548233240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 GARRISON RD",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024454445",
            "telephone_number": "617-277-8107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 GARRISON RD",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024454445",
            "telephone_number": "617-277-8107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANDREA",
        "middle_name": "MOORE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "103118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUESHIELD",
            "identifier": "P10297",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.