Individual provider Active NPI

Patricia J Johnson-Haney, CSAC, LCSW

  • Clinical Social Worker
  • Green Bay, WI
National Provider Identifier
1679025134
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10247-123 Issued in WI
Practice address
971 Riverview Dr
Green Bay, WI 54303-6436
Phone
(920) 680-6662
NPI assigned
Nov 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 16370-132 WI
Clinical Social Worker 1041C0700X 10247-123 WI Primary

Addresses

Primary practice location

971 Riverview Dr
Green Bay, WI 54303-6436

Mailing address

971 Riverview Dr
Green Bay, WI 54303-6436
Phone (920) 680-6662

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
16370-132WIMDAddiction (Substance Use Disorder) Counselor
10247-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Newcap, Inc. PastSince Apr 1, 2025 Accepting new patients
Newcap, Inc. PastSince May 8, 2022 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1477958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1679025134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "971 RIVERVIEW DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543036436",
            "telephone_number": "920-680-6662",
            "fax_number": "920-337-6741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 RIVERVIEW DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543036436",
            "telephone_number": "920-680-6662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON-HANEY",
        "first_name": "PATRICIA",
        "middle_name": "J",
        "credential": "CSAC, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-01",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16370-132",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "10247-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2025; 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.