Active NPI
T. Jeanette Johnson-Watts, LMSW
- Social Worker
- Greenville, SC
National Provider Identifier
1720217417
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 9283
- Practice address
- 124 Mallard St
Greenville, SC 29601-4046 - Phone
- (864) 452-0557
- NPI assigned
- Jul 2, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 9283 | SC | Primary |
| Clinical Social Worker | 1041C0700X |
Addresses
Primary practice location
124 Mallard St
Greenville, SC 29601-4046
Mailing address
124 Mallard St
Greenville, SC 29601-4046
Phone (864) 452-0557
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760596480 | Medicaid | SC |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 9283 | SC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367452800000",
"number": "1720217417",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "124 MALLARD ST",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296014046",
"telephone_number": "864-452-0557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 MALLARD ST",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296014046",
"telephone_number": "864-452-0557"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON-WATTS",
"first_name": "T. JEANETTE",
"name_prefix": "Ms.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-02",
"last_updated": "2013-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "SC",
"license": "9283",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1760596480",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.