Individual provider Active NPI

Andrea Johnston, LCSW-R

  • Clinical Social Worker
  • Saranac Lake, NY
National Provider Identifier
1760570386
Registry record updated Jun 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R070251-1 Issued in NY
Practice address
88 Woodruff St
Saranac Lake, NY 12983-1713
Phone
(518) 354-3386
NPI assigned
Oct 10, 2006
Last updated
Jun 5, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R070251-1 NY Primary

Addresses

Primary practice location

88 Woodruff St
Saranac Lake, NY 12983-1713

Mailing address

37 Curtis Way
Bloomingdale, NY 12913-1707
Phone (518) 354-3386

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20060125000095 NY Practitioner - Clinical Social Worker 8224052626 Practice locations: Malone, NY; Saranac Lake, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

65 Park St
Malone, NY 12953-1239
Phone (518) 354-3386

88 Woodruff St
Saranac Lake, NY 12983-1713
Phone (518) 354-3386

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R070251-1NYMDClinical Social Worker
070251NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Adirondack Social Work Services PC PastSince Jan 1, 1998 Accepting new patients
Essex County Treasurer Past Accepting new patients
Citizen Advocates, Inc PastSince Nov 13, 2017 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401926400000",
    "number": "1760570386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 CURTIS WAY",
            "city": "BLOOMINGDALE",
            "state": "NY",
            "postal_code": "129131707",
            "telephone_number": "518-354-3386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 WOODRUFF ST",
            "city": "SARANAC LAKE",
            "state": "NY",
            "postal_code": "129831713",
            "telephone_number": "518-354-3386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "ANDREA",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2014-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R070251-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saranac Lake, NY

Sources for this page

Verify at the official NPI Registry.