Active NPI
Alexis Johnson, LMSW, CADC
- Clinical Social Worker
- Port Huron, MI
National Provider Identifier
1609118637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Practice address
- 2609 Electric Ave
Ste a
Port Huron, MI 48060-6589 - Phone
- (810) 357-1725
- Fax
- (810) 982-9802
- NPI assigned
- Mar 16, 2013
- Last updated
- Jan 18, 2017
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 2-01129 | MI | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | MI | ||
| Clinical Social Worker | 1041C0700X | 6801091221 | MI | |
| Clinical Social Worker | 1041C0700X | MI | Primary |
Addresses
Primary practice location
2609 Electric Ave
Ste a
Port Huron, MI 48060-6589
Mailing address
2609 Electric Ave
Ste a
Port Huron, MI 48060-6589
Phone (810) 357-1725
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2-01129 | MI | MD | Addiction (Substance Use Disorder) Counselor |
Organizations & group practices 1
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.
-
- Clinical Social Worker
- Fort Gratiot, MI
- NPI 1023415072
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363392000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484697600000",
"number": "1609118637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2609 ELECTRIC AVE",
"address_2": "STE A",
"city": "PORT HURON",
"state": "MI",
"postal_code": "480606589",
"telephone_number": "810-357-1725",
"fax_number": "810-982-9802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2609 ELECTRIC AVE",
"address_2": "STE A",
"city": "PORT HURON",
"state": "MI",
"postal_code": "480606589",
"telephone_number": "810-357-1725",
"fax_number": "810-982-9802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "ALEXIS",
"name_prefix": "Ms.",
"credential": "LMSW, CADC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-03-16",
"last_updated": "2017-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MI",
"license": "2-01129",
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MI",
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801091221",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Huron, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.