Individual provider Active NPI

Rachel Johnson, LCSW

  • Clinical Social Worker
  • Fayetteville, GA
National Provider Identifier
1619485513
Registry record updated Jan 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW006044 Issued in GA
Practice address
729 Highway 314
Fayetteville, GA 30214-3978
Phone
(678) 859-3083
NPI assigned
Jan 14, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X CSW006044 GA Primary

Addresses

Primary practice location

729 Highway 314
Fayetteville, GA 30214-3978

Mailing address

729 Highway 314
Fayetteville, GA 30214-3978
Phone (678) 859-3083

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CSW006044GAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1515888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515888000000",
    "number": "1619485513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 HIGHWAY 314",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302143978",
            "telephone_number": "678-859-3083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 HIGHWAY 314",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302143978",
            "telephone_number": "678-859-3083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RACHEL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-14",
        "last_updated": "2018-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW006044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.