Nicole Johnson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2235-C Issued in AR

Practice address

620 South Laurel Street
Pine Bluff, AR 71601

Phone

(870) 534-4900

Fax

(501) 534-4906

NPI assigned

Dec 18, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Collaborative Counseling Associates, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Little Rock, AR
  • NPI 1922534882
  NPD

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1659434215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 SOUTH LAUREL STREET",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "71601",
            "telephone_number": "870-534-4900",
            "fax_number": "501-534-4906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SOUTH LAUREL STREET",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "71601",
            "telephone_number": "870-534-4900",
            "fax_number": "501-534-4906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": "1868-M",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "2235-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberlee D Johnson, LSW
• Kimiara Johnson
• Leslie Johnson
• Lori Johnson, SLP
• Marsha Johnson
• Ordia Dee Johnson
• Sandra Johnson
• Teaona Johnson
• Whitney Nicole Johnson
• Pamela Jones-Wilkins, BS

• Clinical Social Worker in Pine Bluff, AR
• Providers in Pine Bluff, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2022; 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.