Jennifer R a Johnson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LC19250 Issued in ME

Practice address

216 Vaughan St
Portland, ME 04102-3204

Phone

(207) 662-2221

Fax

(207) 810-2367

NPI assigned

Feb 8, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ME

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

Medicare enrollment (NPD)

Enrolled

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.

• Mainehealth

  • Psychiatric Hospital
  • Westbrook, ME
  • NPI 1790265502
  Medicare reassignment NPD
• Mainehealth

  • Community/Retail Pharmacy
  • Portland, ME
  • NPI 1013868181
  NPD
• Mainehealth

  • Infectious Disease Physician
  • Portland, ME
  • NPI 1073701157
  NPD

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

{
    "created_epoch": "1518048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1649779224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 VAUGHAN ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023204",
            "telephone_number": "207-662-2221",
            "fax_number": "207-810-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 VAUGHAN ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023204",
            "telephone_number": "207-662-2221",
            "fax_number": "207-810-2367"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "135 Westbrook St",
            "address_purpose": "LOCATION",
            "city": "South Portland",
            "state": "ME",
            "postal_code": "04106",
            "country_code": "US",
            "telephone_number": "208-691-1333",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JENNIFER",
        "middle_name": "R A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-08",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC19250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MAINE MASTER OF SOCIAL WORK",
            "identifier": "LM16867",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daly Anne Johnson, PA-C
• Emory Gilbert Johnson III, PHARMD
• Eric Johnson, LCPC
• Gabriel Johnson
• Hannah Johnson
• Jessica Leigh Johnson, FNP
• Jessica Nelson Reade Johnson, RN
• Kaycee Nicole Johnson, CRNA
• Latrice Johnson, MD
• Matthew L Johnson, MD

• Clinical Social Worker in Portland, ME
• Providers in Portland, ME by specialty
• Clinical Social Worker in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; 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.