Mary Kay Johnson, LCSW CSW PIP QMNP

Primary specialty

Social WorkerTaxonomy code 104100000X

License

CSW PIP 1991 Issued in SD

Practice address

1103 Jenson Ave SE
Watertown, SD 57201-5259

Phone

(605) 878-1234

Fax

(605) 878-2211

NPI assigned

Oct 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mary Kay Fischer Former name

Medicare fee-for-service enrollment

Enrolled in SD

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

Specialty

Clinical Social Worker

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Journey Counseling Corp

  • Mental Health Counselor
  • Watertown, SD
  • NPI 1790429652
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1161388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651795200000",
    "number": "1598848921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 JENSON AVE SE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572015259",
            "telephone_number": "605-878-1234",
            "fax_number": "605-878-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 JENSON AVE SE",
            "city": "WATERTOWN",
            "state": "SD",
            "postal_code": "572015259",
            "telephone_number": "605-878-1234",
            "fax_number": "605-878-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARY",
        "middle_name": "KAY",
        "credential": "LCSW CSW PIP QMNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-21",
        "last_updated": "2022-05-06",
        "certification_date": "2022-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SD",
            "license": "LCSW 1557",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "SD",
            "license": "CSW PIP 1991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6571100",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "FISCHER",
            "middle_name": "KAY",
            "credential": "LCSW CSW PIP QMNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Elizabeth Rae Johnson, P.A.
• Francine Johnson
• Isaac George Johnson, DC
• Kenneth M Johnson, MD
• Kristopher B Johnson, MD
• Michael Jerome Johnson, O.D.
• Nicole Johnson
• Scott A Johnson, D.C.
• Casey Johnston
• Kari Joanne Johnston, LPC

• Social Worker in Watertown, SD
• Providers in Watertown, SD by specialty
• Social Worker in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.