Individual provider Active NPI

Lori A Johnson, LMSW

  • Clinical Social Worker
  • Marquette, MI
National Provider Identifier
1760614358
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801091425 Issued in MI
Practice address
102 W Washington St Ste 114
Marquette, MI 49855-4350
Phone
(906) 360-7472
Fax
(906) 273-1177
NPI assigned
Aug 14, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703053213 MI
Clinical Social Worker 1041C0700X 6801091425 MI Primary

Addresses

Primary practice location

102 W Washington St Ste 114
Marquette, MI 49855-4350

Mailing address

117 E Park St
Marquette, MI 49855-3624
Phone (906) 360-7472

Other practice location 1

200 W Spring St
Marquette, MI 49855-4630
Phone (906) 233-1236

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20120726000254 MI Practitioner - Clinical Social Worker 7214193812 Practice locations: Marquette, MI

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

112 W Washington St
Suite a
Marquette, MI 49855-4367
Phone (906) 360-7472

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
6801091425MIMDClinical Social Worker
4703053213MIMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Marquette Counseling Service PastSince Sep 21, 2011 Accepting new patients

Organizations & group practices 1

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": "1250208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1760614358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 E PARK ST",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498553624",
            "telephone_number": "906-360-7472",
            "fax_number": "906-273-1177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W WASHINGTON ST STE 114",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498554350",
            "telephone_number": "906-360-7472",
            "fax_number": "906-273-1177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 W Spring St",
            "address_purpose": "LOCATION",
            "city": "Marquette",
            "state": "MI",
            "postal_code": "498554630",
            "country_code": "US",
            "telephone_number": "906-233-1236",
            "fax_number": "906-233-1235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LORI",
        "middle_name": "A",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-14",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703053213",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801091425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

Verify at the official NPI Registry.