Jacquelyne Johnson, LICSW,PIP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1394-3879C Issued in AL

Practice address

9018 Cotton Field Cir
Tuscaloosa, AL 35405-9643

Phone

(205) 292-8276

NPI assigned

Apr 16, 2018

Last updated

Apr 16, 2018By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jacquelyne.johnson.1@30520.direct.athenahealth.com

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.

• Step by Step Counseling and Consulting Services, LLC

  • Clinical Social Worker
  • Tuscaloosa, AL
  • NPI 1780335497
  NPD Authorized official
• Doctor on Demand Professionals P C

  • Family Medicine Physician
  • San Francisco, CA
  • NPI 1174931448

  MA

  Medicare reassignment

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

{
    "created_epoch": "1523836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1548757594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9018 COTTON FIELD CIR",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354059643",
            "telephone_number": "205-292-8276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9018 COTTON FIELD CIR",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354059643",
            "telephone_number": "205-292-8276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JACQUELYNE",
        "credential": "LICSW,PIP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-16",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "1394-3879C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colleen Ruth Johnson, PT
• Dawn L Johnson, O.D.
• Ellory Kate Johnson, MD
• Ernest Van Johnson, M.D.
• Ianswer Johnson, MPH, CHES
• Jamie Devon Johnson, DMD
• Keniece Johnson
• Kloi E Johnson
• Kyle S Johnson, MD
• Linda Black Johnson, LCSW

• Clinical Social Worker in Tuscaloosa, AL
• Providers in Tuscaloosa, AL by specialty
• Clinical Social Worker in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.